Writing an Effective Work Accommodation Note in Pennsylvania

If your patient does NOT work in Philadelphia (i.e., works in another city in Pennsylvania): You may click the blue button below to create a work accommodation note by using an interactive tool that asks you to answer questions about your patient’s medical condition and work limitations. You will not be asked to enter your patient’s name or any other personally identifiable information about your patient. This interactive tool produces text that can be cut and pasted onto your professional letterhead. If your patient WORKS IN PHILADELPHIA, the interactive tool should not be used, and instead you should download the instructions for writing your own note, below.

Write Your Own Note

Click the button below to download step-by-step instructions on how to write an effective work note in Pennsylvania.

New rights for pregnant, postpartum, and lactating workers take effect June 27, 2023!
Learn more about the Pregnant Workers Fairness Act.