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BREASTFEEDING ACCOMMODATION FORM Please note: The Breastfeeding Accommodation Form is ideally submitted with FMLA paperwork or, if practical, at least 30 days prior to when maternity leave is expected
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How to fill out breastfeeding accommodation form

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How to fill out breastfeeding accommodation form

01
Start by obtaining a copy of the breastfeeding accommodation form. You can typically get this form from your employer or human resources department.
02
Read the form thoroughly to understand the information you will need to provide and any specific guidelines or instructions.
03
Begin by filling out your personal details, including your name, employee ID, contact information, and the date.
04
Provide details about your workplace, such as the department, job title, and supervisor's name.
05
Indicate the specific accommodation you are seeking for breastfeeding, whether it's a private room, flexible break schedule, or other arrangements.
06
Explain the frequency and duration of the accommodations needed, mentioning the approximate times you will require breaks for breastfeeding.
07
If applicable, mention any equipment or resources you might need, such as a breast pump or storage facilities.
08
Acknowledge your understanding of any policies or procedures related to the accommodation request.
09
Sign and date the form to certify the accuracy of the provided information.
10
Submit the completed form to the appropriate authority or department, as specified by your employer.

Who needs breastfeeding accommodation form?

01
Any breastfeeding employee who requires accommodations in the workplace is eligible to fill out a breastfeeding accommodation form.
02
This includes new mothers who are returning to work and need provisions for breastfeeding or expressing milk during their working hours.
03
Many jurisdictions have laws in place that protect a breastfeeding employee's right to request and receive accommodations, making the form necessary.
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The breastfeeding accommodation form is a document that allows employees to request accommodations for breastfeeding at work.
Pregnant or nursing employees who require accommodations for breastfeeding are required to file the breastfeeding accommodation form.
Employees can fill out the breastfeeding accommodation form by providing their personal information, details of their breastfeeding needs, and any specific accommodations required.
The purpose of the breastfeeding accommodation form is to ensure that employees are able to continue breastfeeding while at work by requesting necessary accommodations.
The breastfeeding accommodation form must include the employee's name, contact information, breastfeeding needs, requested accommodations, and any supporting documentation.
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