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Disability Access Office (DAY) Human Resources. P.O. Box 1569 ... S: Disability Access Office Templates A Work Accommodation Request Revised 12-2013.

How to fill out work accommodation request form

How to fill out a work accommodation request form?

1. Start by obtaining a copy of the work accommodation request form from your HR department or employer. It may be available online or in a physical format.
2. Read the instructions carefully to understand the information and documents required to complete the form. Gather any necessary supporting documents such as medical reports or recommendations from healthcare professionals.
3. Begin by filling out your personal information section. This includes your full name, contact details, and employee identification number.
4. Specify the nature of your request by providing detailed information about your specific accommodation needs. Describe any medical conditions, disabilities, or limitations that require accommodation in the workplace.
5. Explain the specific accommodations you are requesting. Be clear and concise in outlining the modifications or adjustments you believe will enable you to perform your job duties effectively.
6. If applicable, provide a timeline or duration for which the accommodation is needed. This can be temporary or permanent depending on the circumstances.
7. Indicate any relevant medical professionals or experts who can support your request. Include their contact information and any relevant documentation they have provided regarding your condition or need for accommodation.
8. Review the completed form to ensure all the necessary information has been filled out accurately. Consider seeking assistance from a trusted colleague or supervisor to ensure clarity and completeness.
9. Once you are satisfied with the information provided, sign and date the form. Make a copy for your records before submitting it to the appropriate department or individual specified by your employer.

Who needs a work accommodation request form?

1. Employees with disabilities or medical conditions that require workplace accommodations may need to fill out a work accommodation request form.
2. Individuals who experience limitations or difficulties performing their job duties due to health-related issues might need to submit this form.
3. Employees seeking modifications or adjustments to their work environment, such as ergonomic furniture, assistive technology, or flexible scheduling, may also require a work accommodation request form.

Remember, the specific requirements and process for filling out this form may vary depending on your company's policies and local laws. It's important to consult your HR department or supervisor for guidance and support throughout the process.

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What is work accommodation request form?

The work accommodation request form is a document used by employees to request accommodations in the workplace due to a medical condition or disability.

Who is required to file work accommodation request form?

Any employee who requires accommodations in the workplace due to a medical condition or disability is required to file a work accommodation request form.

How to fill out work accommodation request form?

To fill out a work accommodation request form, employees must provide information about their medical condition or disability, specify the accommodations needed, and submit the form to their employer.

What is the purpose of work accommodation request form?

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

What information must be reported on work accommodation request form?

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