Form

Health Adjustment Passport: completion notes

Updated 12 June 2023

This information sheet is designed to help you complete the Health Adjustment Passport.

What is the Health Adjustment Passport and who is it for?

The Health Adjustment Passport is a document which can:

• support you to identify what support and changes (known as reasonable adjustments) you may need when you are in work or moving into work
• help you to apply for support from Access to Work, which could include:
  • funding for specialist equipment to support you to do your job, and
  • support getting to and from work or support when you are in work, such as job coaching
• help you talk to employers about adjustments and in-work support that you may need

Completing the passport can be useful for people who face barriers in the workplace due to a disability or health condition.

How to complete the form

About You

Questions 1 to 3

Please complete with the information requested.

Question 4

Think about why you want to work in this location, is it because:

• it is near to home, and you need to be near to home because of a health condition or disability?
• Is it because you feel you cannot travel due to your disability or health condition?

Question 5

Think about what type of work you want to do. It could be a specific job role, or an employment sector. If the employment sector you want to work in is new to you, have you not worked in it before because of a disability or health condition?

Helpful note: In each subsequent section please read the prompts beneath each question and tick one of the boxes marked Yes or No.

Provide more detail in the free text box if necessary. Please skip to the relevant question as per the instructions on the form.

There are some things to consider for each free text question below. The examples provided are not exhaustive.

About your health (Questions 6 – 8)

Question 6

Think about how you:

• manage daily activities such as cooking or getting dressed. You could also consider
• communicate with other people, i.e., do you need someone to support you or prompt you to engage with another person
• move around, do you use a wheelchair, or do you need accompanying when leaving the house

Do you have any impairments which affect your sight or hearing – if so, how do you manage these. Include as much detail as you can in the free text box.

Question 7

Your health condition may vary, either throughout the day, during the week, or yearly. If this is the case, in the free text box think about what additional help you may need when your condition is at its worse.

For example-

• is your health condition worse in the morning before your medication has taken affect, or
• do seasonal changes impact on your condition for example, is your visual impairment worse during the winter months due to it going dark earlier

Question 8

The free text box in this section can be used to record support you may have had previously. It could include things like:

• being allowed additional time in exams
• having a personal reader to dictate questions
• having been supported at University through Disabled Students allowance
• reasonable adjustments that have been provided in a previous job role, such as flexible work times or increased breaks

About work (Questions 9 – 17)

Question 9

Think about any barriers you may face due to your disability or health condition when travelling to work, or any difficulties you have with planning and undertaking a journey. This could include:

• experiencing anxiety when using public transport if travelling during busy periods,
• you are unable to use public transport, or
• you can no longer drive because of a disability or health condition

Question 10

When you arrive at work, is there any support you need to be able to access the work premises? This could include:

• a lift
• a ramp
• widened doors if you are a wheelchair user
• clear signage is required if you are visually impaired

Question 11

When considering if you need support to interact with other people, think about an interview process. Would you need someone to:

• provide moral support during an interview
• prompt you to provide enough information or to prevent you providing too much information
• take notes on your behalf because you struggle to retain a lot of information or are unable to take notes yourself

Would you require a British Sign Language interpreter or maybe a Lip speaker so you can communicate with others?

Question 12

Think about what you have used previously. There are some common software packages listed on the form, but if you have used other software provide details of the software in the free text box. If you cannot remember the name of the software, then explain briefly what the software did or how it helped you.

Question 13

If you need software (identified in Q12), would you require training to use it? Please list which software you would require training in.

Question 15

If you have previously used specialist equipment to overcome barriers at work, explain what you have used in the free text box.

There are many forms of specialist equipment, this can include:

• specialist computer hardware such as mice, keyboards, number pads or large monitors
• specialist furniture such as height adjustable desks, ergonomic chairs, footrests, and armrests
• magnifiers, braille readers or hearing aids and wheelchairs

Question 16

Think about standard adjustments you may have had in the past, and any that may benefit you due to a disability or health condition. Things to consider:

• where you are situated in an office i.e., sat away from an entrance or exit, not sat in an aisle seat or sat either close to or far from a toilet, OR
• adjustments to lighting for example, lights which are dimmable or LED lightbulbs which don’t flicker

Question 18

Think about the support another person could provide. This could be a:

• job coach because it takes you longer to learn a new job role
• support worker to help you with personal care needs whilst in work
• support worker to help with certain aspects of a job or it could be a British Sign Language Interpreter

In addition, think about if you need support to engage with other people, would you need someone to help you manage relationships with colleagues or your manager or someone to help explain rules to you?

Applying for help – Access to Work

The final section of the Health Adjustment Passport is about Access to Work. If you require support to move in to or to remain in work, you can make a claim to Access to Work. But you must have an offer of a job or job interview.

If you do make a claim to Access to Work and support is offered, ensure you update your Health Adjustment Passport with details of what support you received. This can support you if you move job roles or employers.

What should I do with a completed Health Adjustment Passport?

Once you have completed the Health Adjustment Passport you can print it out or save it to a computer or mobile device. This will allow you to update it or amend it in future.

You can use a completed Health Adjustment Passport to support an application to Access to Work and reduce the need for an assessment enabling support to be put in place more quickly. The passport can also support discussions with your employer or a potential employer by providing you with an overview of the support you need to overcome barriers due to your disability or health condition.

If you have a Job Centre Plus work coach, you can show it to them to discuss any reasonable adjustments or support you may require when talking about work opportunities.

It is important to note:

• the information contained within the Health Adjustment Passport is your information, and it cannot be shared without your consent
• it is your responsibility to keep the completed document