Get the free WORK ACCOMMODATION REQUEST FORM

Certification of Request I voluntarily request I be provided with the above indicated work accommodations in compliance with the California Fair Employment Housing Act FEHA /Americans with Disabilities Act ADA. I understand that Riverside County requires I provide medical documentation supporting this request and the determination of whether or not I am eligible for accommodation is contingent upon such documentation. Moreover I understand under FEHA/ADA only reasonable accommodations that do...

How to fill out work accommodation request form

How to fill out work accommodation request form

1. Read the instructions on the work accommodation request form carefully.
2. Provide your personal information such as name, contact details, and employee ID.
3. Specify the reason for your work accommodation request and provide details of your medical condition, if applicable.
4. Indicate the type of accommodation you are requesting and provide any necessary supporting documents.
5. Include any specific recommendations or suggestions for accommodation that you may have.
6. Sign and date the form.
7. Submit the completed work accommodation request form to your supervisor or the appropriate department.
8. Follow up with any additional information or documentation that may be required.
9. Keep a copy of the filled out form for your records.

Who needs work accommodation request form?

1. Employees who have a medical condition or disability that requires accommodation in the workplace.
2. Employees who are temporarily or permanently unable to perform certain job tasks without accommodation.
3. Employees who have been advised by a healthcare professional to request workplace accommodation.
4. Employees who require adjustments or modifications to their work environment or schedule.
5. Employees who need assistance or support to perform their job duties due to a medical condition or disability.

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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 who have a disability or medical condition.

Who is required to file work accommodation request form?

Employees with disabilities or medical conditions who require accommodations in the workplace 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 details about their disability or medical condition, the accommodations they are requesting, and any supporting documentation.

What is the purpose of work accommodation request form?

The purpose of the work accommodation request form is to help employees with disabilities or medical conditions receive the accommodations they need to perform their job effectively.

What information must be reported on work accommodation request form?

The work accommodation request form must include information about the employee's disability or medical condition, the requested accommodations, and any supporting documentation.