Get Reasonable Accommodation Request Form

This guide provides clear, step-by-step instructions on how to complete the Reasonable Accommodation Request Form online. By following these steps, you can efficiently submit your request for accommodations, ensuring you receive the necessary support in your workplace.

Follow the steps to fill out the Reasonable Accommodation Request Form online.

1. Click ‘Get Form’ button to access the Reasonable Accommodation Request Form and open it in your preferred online editor.
2. Enter today's date in the designated field to ensure accurate record-keeping.
3. Provide your employee ID number and birthdate in the specified sections to verify your identity.
4. Fill in your full name along with your job title and department to give context to your request.
5. Identify your immediate supervisor and include their phone number to establish a point of contact.
6. Complete the contact information section, including your home address, email, work phone, and home phone.
7. Describe your job responsibilities briefly, and attach your current job description if available.
8. Detail the aspects of your work that are impacted by your condition and explain how they are affected.
9. Answer the medical diagnosis section, specifying the condition for which you are requesting accommodations.
10. Indicate whether your condition limits any major life activities, and provide details about the affected activities.
11. Specify if your condition is temporary or permanent, and if temporary, note the expected duration.
12. List the reasonable accommodations you are requesting, ensuring they are clear and specific.
13. Provide suggestions for any additional accommodations that may address your needs.
14. Estimate the duration for which you will need the accommodation to facilitate planning.
15. Explain how the requested accommodation will assist you in performing the essential functions of your job.
16. Answer the yes/no questions regarding previous participation in the Return to Work Program and any prior accommodation requests.
17. Sign and date the form to affirm that the information provided is accurate and that you will cooperate fully with the process.
18. Once completed, save your changes, and proceed to download, print, or share the form as needed.

Begin your Reasonable Accommodation Request today and ensure you receive the support you need in your workplace.