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EMPLOYMENT ACCOMMODATION REQUEST FORM: CONFIDENTIAL Intake Date: NAME: DATE OF BIRTH : FEMALE MALE HIRE DATE: UID: SUPERVISOR: POSITION: POSITION APPLIED FOR: CAMPUS ADDRESS: PHONE NUMBER: HOME ADDRESS:
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How to fill out employment accommodation request form

01
The first step in filling out an employment accommodation request form is to carefully read the instructions provided. This will help you understand the purpose of the form and the information you need to provide.
02
The form usually starts with the personal information section. You will need to provide your full name, contact details, and employee identification number, if applicable. Make sure to write legibly and double-check the accuracy of the information.
03
Next, you may be required to provide details about your current job position. This could include your job title, department, and supervisor's name. Some forms may also ask for the date of your employment start.
04
The following section generally covers the accommodation request itself. Clearly state the nature of the accommodation you are seeking and provide a detailed explanation of why it is necessary. Be specific about the job tasks or work environment that are affected and how the accommodation would enable you to perform your duties effectively.
05
If applicable, you may need to attach supporting documentation, such as medical records or recommendations from healthcare professionals. Make sure all attachments are clearly labeled and relevant to your request.
06
In some cases, the form may include a section for the employer's response. This allows them to indicate whether they approve or deny the accommodation request. Ensure that you have clearly provided your preferred method of communication for the employer's response, such as phone or email.
Who needs an employment accommodation request form?
01
Employees who have a disability or medical condition that affects their ability to perform certain job tasks may need to complete an employment accommodation request form. This form allows them to formally request reasonable accommodations that would enable them to fulfill their job responsibilities.
02
Individuals who have identified workplace barriers that prevent them from fully participating due to their religious beliefs may also require an employment accommodation request form. These individuals can use the form to request accommodations that align with their religious practices.
03
Additionally, employees who are pregnant or have recently given birth may need to fill out an employment accommodation request form to request accommodations related to their pregnancy or postpartum recovery. These accommodations may include schedule adjustments, modified duties, or temporary leave.
04
It is important to note that the need for an employment accommodation request form may vary depending on local laws and company policies. It is advisable to consult your employer's human resources department or review your company's accommodation policies to determine the specific requirements and procedures for requesting accommodations.
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What is employment accommodation request form?
The employment accommodation request form is a document used by employees to request accommodations in the workplace due to medical conditions or disabilities.
Who is required to file employment accommodation request form?
Employees who require accommodations in the workplace due to medical conditions or disabilities are required to file the employment accommodation request form.
How to fill out employment accommodation request form?
Employees can fill out the employment accommodation request form by providing information about their medical condition, specific accommodations needed, and any supporting documentation from a healthcare provider.
What is the purpose of employment accommodation request form?
The purpose of the employment accommodation request form is to ensure that employees with medical conditions or disabilities have the necessary accommodations to perform their job duties effectively.
What information must be reported on employment accommodation request form?
Information such as the employee's medical condition, specific accommodations needed, and any supporting documentation from a healthcare provider must be reported on the employment accommodation request form.
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