Dear Healthcare Provider/Specialist:
The purpose of this request is to help Yale University identify a reasonable accommodation for your patient that will help them perform their job duties and/or enjoy equal benefits and privileges of employment.
All of the questions below only apply to the condition for which the patient is seeking an accommodation. All medical details will be treated as confidential information.
The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits employers and other entities covered by GINA Title II from requesting or requiring genetic information of an individual or family member of the individual, except as specifically allowed by this law. To comply with this law, we are asking that you not provide any genetic information when responding to this request for medical information. "Genetic information," as defined by GINA, includes an individual's family medical history, the results of an individual's or family member's genetic tests, the fact that an individual or any individual's family member sought or received genetic services, and genetic information of a fetus carried by an individual or an individual's family member or an embryo lawfully held by an individual or family member receiving assistive reproductive services.