England & Walesreasonable-adjustments

Reasonable Adjustment Request Letter (England & Wales)

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REASONABLE ADJUSTMENT REQUEST TEMPLATE

letter date

Dear manager name,

I'm writing to make a reasonable adjustment request to help me manage my health at work.

health context

My current working pattern and role is current role and pattern.

To help me manage my work and health I ask that requested adjustment.

This would mean that I can employer benefit.

To deal with any effects the change could have on my work or the organisation, I suggest mitigation suggestion.

Please could we meet to talk about my reasonable adjustment request.

I look forward to your reply.

Yours sincerely,

employee name

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This is a process template, not legal advice. Employers have a legal duty to make reasonable adjustments under the Equality Act 2010 (ss.20-21). If you're unsure whether your situation is covered, or your employer refuses your request, get independent advice before you proceed.
This document is provided as a template for information purposes and is not legal advice.
For advice on a specific situation, consult a qualified adviser or Acas (acas.org.uk).

Variables you will fill in

Letter date(date)required
Manager / employer / HR manager name(text)required
How your health affects your work, or your work affects your health(textarea)required
You do not need to share your diagnosis or disability status to make this request — describing how it affects your work is enough, though sharing more can help your employer understand your needs.
Your current working pattern and role(textarea)required
The adjustment you're asking for, and why(textarea)required
Any benefit to the employer (optional but often helpful)(textarea)
How any effects on your work or the organisation could be managed(textarea)
Your name (signatory)(text)required

This information is for informational purposes only and does not constitute legal advice. For advice on a specific situation, consult a qualified adviser or Acas (acas.org.uk).