on Demand
Please complete the following and use the "submit" button to send your request for information to the JAN staff. Your request will be forwarded to a JAN Consultant who will e-mail a response.
Your Name:
Your E-mail Address*: (Required) Please double check your e-mail address.
Your State: Non-USA Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
I am contacting you as:
an employer,
an individual with a disability,
a rehabilitation professional,
a family member or friend, or
other.
2. What is the job title of the employee?
3. What specific duties are an issue? (For example, must type approximately 6 hours per day at 50 wpm OR due to medication needs to work straight schedule and laborer job requires rotating shift.)
4. What equipment or physical barriers used in the work setting are an issue (specific equipment with make and model when possible)?
5. What company policy is related to the need for accommodation? (For example, attendance policy.)
6. List/summarize any accommodations that have been attempted or requested.