Workplace Accommodation Request

Workplace Accommodation Request — Form Fields

This hr template includes 7 fields. Enable employees with disabilities or medical conditions to formally request reasonable workplace accommodations. Free to customize and use on ZenBuild.

• Employee Name (text, required)
• Job Title (text, required)
• Work Email (email, required)
• Describe the Limitation or Condition Requiring Accommodation (long text, required)
• Accommodation(s) Being Requested (long text, required)
• Have you discussed this with your manager? (multiple choice, required) — options: Yes, No, I prefer to handle this through HR only
• Supporting Documentation (optional) (file upload, optional)