Neurodiversity Workplace Support Request

Neurodiversity Workplace Support Request — Form Fields

This hr template includes 7 fields. Employees with neurodiverse conditions request specific workplace accommodations. Free to customize and use on ZenBuild.

• Employee Name (text, required)
• Job Title (text, required)
• Department (text, required)
• Primary Support Area (dropdown selection, required) — options: Sensory environment, Communication, Task structure, Scheduling, Technology tools, Other
• Describe the specific adjustment needed (long text, required)
• Do you have supporting documentation from a healthcare provider? (multiple choice, required) — options: Yes, No
• Any additional context you'd like HR to know (long text, optional)