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Workplace Accommodation Request Form - Free HR Template | ZenBuild | ZenBuild

Templates→HR→Workplace Accommodation Request Form

Workplace Accommodation Request Form

Enable employees to formally request workplace accommodations for medical, disability, or accessibility needs.

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Workplace Accommodation Request Form

Submit this form to request a workplace accommodation. Your request will be reviewed by HR in confidence.

Employee Full Name*

Work Email Address*

Job Title*

Type of Accommodation Needed*

Description of Accommodation Needed*

Do you have supporting medical documentation?*

Yes, I can provide documentationNo, I do not have documentationI will obtain documentation

Upload Supporting Documentation (Optional)

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Template Details

CategoryHR

IndustryHuman Resources

Fields7

Uses0

Views0

hraccessibilityaccommodationdisabilitycompliance