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Request for Workplace Accommodation Form (to be completed by employee) Employee Name Employ Date Job Title Department Ext. Type of Accommodation Requested schedule change work site modification of
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How to fill out request for workplace accommodation

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How to fill out request for workplace accommodation

01
Step 1: Start by identifying the specific accommodation you need in the workplace.
02
Step 2: Research and familiarize yourself with the company's policies and procedures regarding accommodation requests.
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Step 3: Write a formal request letter addressing it to your supervisor or the HR department.
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Step 4: Clearly state the reason for your request and any relevant medical documentation or professional recommendations.
05
Step 5: Provide specific details about the accommodation you are seeking, such as changes to your work schedule, modifications to your workstation, or additional equipment needed.
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Step 6: Mention any potential benefits or improvements that the accommodation would bring to your productivity and work performance.
07
Step 7: Request a meeting with your supervisor or HR representative to discuss your request further and address any concerns or questions they may have.
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Step 8: Keep a copy of your request and any supporting documents for your records.
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Step 9: Follow up on your request if you don't receive a response within a reasonable timeframe.
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Step 10: Cooperate with your employer during the interactive process of determining the feasibility and implementation of the accommodation.
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Step 11: Once approved, maintain open communication with your employer regarding the effectiveness of the accommodation and any adjustments that may be needed.

Who needs request for workplace accommodation?

01
Individuals with disabilities who require reasonable adjustments or modifications in order to perform essential job functions.
02
Employees with medical conditions or injuries that may affect their ability to adequately perform duties without certain work-related changes.
03
Pregnant employees who need temporary accommodations to ensure their health and well-being during pregnancy.
04
Workers recovering from surgery or serious illness who may need temporary modifications or reduced workloads to facilitate their recovery.
05
Employees experiencing limitations due to aging or age-related conditions that may require adjustments to their work environment or tasks.
06
Individuals with mental health conditions or cognitive impairments that may require accommodations to support their functioning and productivity in the workplace.
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A request for workplace accommodation is a formal application made by an employee to ask for adjustments or modifications to their work environment or duties in order to accommodate a disability or medical condition.
Any employee who requires an accommodation due to a disability or medical condition is required to file a request for workplace accommodation.
To fill out a request for workplace accommodation, an employee typically needs to provide information about their disability or medical condition, describe the specific accommodations they are requesting, and submit any supporting documentation.
The purpose of a request for workplace accommodation is to ensure that employees with disabilities or medical conditions are able to perform their job duties effectively and without discrimination.
The information reported on a request for workplace accommodation may include details about the employee's disability or medical condition, the specific accommodations being requested, and any supporting documentation from healthcare providers.
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