Adjustment Passport Adjustment DetailsDo you have a health condition or disability which could meant you might benefit from adjustments at work?(Required)NoYesName(Required) First Last Date(Required) DD slash MM slash YYYY Volunteering Location(Required) My health condition or impairment interacts with barriers within the workplace to create the following impact(s) on me at work:(Required)I would like to discuss the following adjustments which could support me at work:(Required)Do you have any additional advice/information from a professional that you would like to share with us?(Required)NoYesPlease share the advice/information given below(Required)Please include who gave you the information and the date this was sharedFile Drop files here or Select files Max. file size: 2 GB. If you have any specific files you would like to share with us that will help us better understand your needs, please upload them here