ADA Rights Workshop

Dear (Name of General Counsel):

I am a patient at (Hospital Name).

My functional limitation is that I have [or care for a loved one that has] a medical condition that, according to the CDC, makes me high risk for severe COVID outcomes. I am requesting reasonable accommodation in the form of universal masking, as guaranteed by the Americans with Disabilities Act for safe healthcare, pursuant to my right to “full and equal access” to health care services under federal law (28 C.F.R. § 35.151 (Title II); 28 C.F.R. Part 36, Subpart D (Title III)). I request:

1. A guarantee that I will not encounter a single unmasked person for the duration of my visit, including other visitors, hospital staff;
2. To wait in my car or outside until called;
3. To use an entrance that is not used by unmasked people;
4. All of my providers wear an N95 mask at all times in my presence;
5. Additional air ventilation provided for my visit, I am happy to bring my own HEPA purifier to assist with this;
6. I will be seen, treated, and in post-op in a private room which I will not share with any other patient. I request that this room be cleaned by only masked staff, and that an air purifier be run for 30 minutes before I enter.
7. All providers who see me will certify that they have not tested positive for COVID nor been exposed to COVID in the past ten days, and complete a COVID symptom screening
8. If I am operated on, I request that I remain masked if possible, and if not, that a mask be put on me immediately following my procedure.

I would appreciate a written response to this letter. Please confirm how you will be able to meet my request. Please contact me if you have any questions about my request. Thank you very much.

Respectfully,

(Your name)