Is this template free?

You can preview the full template and fill it in for free — the preview is watermarked. To download a clean copy you need a paid plan or pack.

Is it legally accurate?

It's a faithful, diff-verified reproduction of the ACAS source, checked by a deterministic diff (not a legal review, and not approved by ACAS). It's general information, not legal advice.

What is a reasonable adjustment?

A change an employer makes so a disabled person isn't put at a substantial disadvantage compared with others — for example changing a task, providing equipment, or adjusting hours. What's "reasonable" depends on the situation.

Is this the same as an Equality Act reasonable adjustments letter?

Yes. A reasonable adjustments letter and an Equality Act reasonable adjustments letter both describe the same thing — a written request for a reasonable adjustment under the Equality Act 2010, which is what this template is.

Can I use this to request adjusted duties?

Yes. Adjusted duties — changing some of your tasks or responsibilities — is one type of reasonable adjustment you can request. Describe it in the template's "adjustment you're asking for" field.

How do I write a reasonable adjustments letter?

Fill in this template's fields — how your health affects your work, your current role, and the adjustment you're asking for and why — then preview it for free. Sign in to download a clean copy to send to your employer.

England & Walesreasonable-adjustments

Reasonable Adjustment Request Letter (England & Wales)

This is a static, verified master template. AI never generates the clause text below — it only helps you fill in the variable fields after you sign in.

About this template

This reasonable adjustments letter is used to ask an employer, in writing, for a change that removes a disadvantage at work for a disabled worker or job applicant — for example adjusted duties, equipment, or how and where work is done. Under the Equality Act 2010, employers have a duty to make reasonable adjustments. This template gives you a clear, structured request to fill in with your own details. It's based on the ACAS reasonable-adjustments materials, and it sits within Verstia's Reasonable Adjustments process pack, which walks through the whole procedure in order.

When to use it: When you (or someone you're helping) need to put a reasonable-adjustment request to an employer in writing.
What's included: Fill-in fields for the person's and employer's details, the adjustment being requested, and the barrier it addresses.

This document's core is based on a template published by ACAS (inferred to be under OGL-3.0, from ACAS's site-wide licensing notice — not a template-specific statement). Verstia does not claim this text is approved by ACAS — its fidelity to the source is verified by a deterministic diff, not a legal review.

Template preview

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 datedaterequired
Manager / employer / HR manager nametextrequired
How your health affects your work, or your work affects your healthtextarearequired
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 roletextarearequired
The adjustment you're asking for, and whytextarearequired
Any benefit to the employer (optional but often helpful)textarea
How any effects on your work or the organisation could be managedtextarea
Your name (signatory)textrequired

Part of the Reasonable Adjustments Process Pack (England & Wales) — see all documents and the step-by-step guide

Frequently asked questions

Is this template free?: You can preview the full template and fill it in for free — the preview is watermarked. To download a clean copy you need a paid plan or pack.
Is it legally accurate?: It's a faithful, diff-verified reproduction of the ACAS source, checked by a deterministic diff (not a legal review, and not approved by ACAS). It's general information, not legal advice.
What is a reasonable adjustment?: A change an employer makes so a disabled person isn't put at a substantial disadvantage compared with others — for example changing a task, providing equipment, or adjusting hours. What's "reasonable" depends on the situation.
Is this the same as an Equality Act reasonable adjustments letter?: Yes. A reasonable adjustments letter and an Equality Act reasonable adjustments letter both describe the same thing — a written request for a reasonable adjustment under the Equality Act 2010, which is what this template is.
Can I use this to request adjusted duties?: Yes. Adjusted duties — changing some of your tasks or responsibilities — is one type of reasonable adjustment you can request. Describe it in the template's "adjustment you're asking for" field.
How do I write a reasonable adjustments letter?: Fill in this template's fields — how your health affects your work, your current role, and the adjustment you're asking for and why — then preview it for free. Sign in to download a clean copy to send to your employer.

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).