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RIVERSIDE COUNTY DISABILITY ACCESS OFFICE WORK ACCOMMODATION REQUEST FORM I. General Information Name of Employee: Employee #: Position: Supervisor: Department: II. Type of Accommodation Requested

How to fill out work accommodation request form

How to fill out work accommodation request form

1. Open the work accommodation request form.
2. Read the instructions carefully before filling out the form.
3. Enter your personal details such as name, contact information, and employee ID.
4. Specify the type of accommodation you are requesting.
5. Clearly explain the reason for the accommodation request.
6. If applicable, provide supporting documentation or medical reports.
7. Indicate any specific dates or duration for which the accommodation is required.
8. If there are any particular preferences or requirements, mention them in the form.
9. Review all the information entered for accuracy and completeness.
10. Submit the completed form to the appropriate department or HR personnel.
11. Keep a copy of the filled-out form for your records.

Who needs work accommodation request form?

1. Employees who require workplace accommodations due to a disability or medical condition.
2. Employees who have temporary or long-term limitations that affect their job performance.
3. Employees who need adjustments to their work environment, tasks, or schedules.
4. Employees who face barriers or difficulties performing essential job functions.
5. Employees who want to request reasonable accommodations to ensure equal opportunities.

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What is work accommodation request form?

Work accommodation request form is a document used to request accommodations in the workplace for employees with disabilities or other medical conditions.

Who is required to file work accommodation request form?

Employees who require accommodations in the workplace due to disability or medical condition are required to file a work accommodation request form.

How to fill out work accommodation request form?

Employees can fill out the work accommodation request form by providing their personal information, details of their disability or medical condition, and requesting specific accommodations needed.

What is the purpose of work accommodation request form?

The purpose of the work accommodation request form is to ensure that employees with disabilities or medical conditions are provided with reasonable accommodations to perform their job duties effectively.

What information must be reported on work accommodation request form?

Information such as employee's personal details, nature of disability or medical condition, requested accommodations, and any supporting documentation may be required on the work accommodation request form.