Reasonable Adjustment Passport

For the purposes of the Equality Act 2010 and the Disability Discrimination Act 1995, a disability is defined as a substantial and long-term adverse effect on your ability to carry out normal day to day activities which has lasted or is likely to last for 12 months or more. This includes fluctuating conditions, including mental health problems, and
includes HIV, cancer, and MS from the point of diagnosis.

Disability Labour supports the campaign for a social model and definition of Disability. In equality legislation and many legal documents, the universal definition of disability is taken from the medical model. Although it is widely agreed that a social model of disability should also be used to create greater awareness of how the appropriate designs can benefit all members of the community.

Is this the first time you have completed this form or is this a review of an existing one?

First Time
Review

If a review, what has changed to prompt the review?

Part 1 – The Barriers I experience

Thinking of the tasks you undertake; please explain the barriers you face due to your disabilities or conditions: An example: I experience fatigue in the morning due to medication which causes issues with concentration

Part 2 – Adjustments Required

Please list the adjustments you need to prevent or reduce the barriers you experience in attending meetings Physical / Virtual: An example: Late start at 10.30am

Part 3 – Outcomes

So that we can ensure that these are the right adjustments for you, please explain how each of the adjustments you requested in Part 2 will prevent or reduce the barriers you listed in Part 1 For example: A late start will allow my fatigue to pass and I will be able to fully concentrate when I get to work.

3 Barriers experience

Part 4 – Name

I will let Disability Labour know if there are changes to my condition or impairment which have a positive or negative effect on any of my agreed adjustments.