Get Wcpss Accommodation Form

The Wcpss Accommodation Form is designed to help employees request necessary accommodations due to various conditions or situations. This guide will provide you with clear and concise steps to effectively complete the form online.

Follow the steps to successfully submit your accommodation request.

1. Press the ‘Get Form’ button to access the accommodation form and open it in your online editor.
2. Begin filling out the personal information section. Provide your name, position, employee number, work site, and home address. Ensure the accuracy of your email and phone number for effective communication.
3. List your supervisor(s) along with their respective phone numbers, including work, cell, and home numbers as required.
4. Indicate whether you have received or are applying for disability or workers’ compensation benefits by checking the appropriate box.
5. Detail the situation that is prompting your accommodation request. Be specific about the nature of your impairment or condition, whether it is chronic or temporary.
6. Describe your current employment conditions, including if your position is permanent or temporary, whether you are full-time or part-time, and your contract status if applicable. Also, state the number of hours worked per week and your employment start date.
7. List all responsibilities associated with your current employment role. Include as many details as possible to provide a comprehensive overview.
8. Describe the specific job responsibilities that would be impacted by the accommodations you are requesting.
9. Clearly outline the accommodations you are proposing and ensure they are specific and relevant to your needs.
10. Specify the anticipated length of time for the requested accommodations.
11. Sign the form electronically or write your name and date, confirming that the information provided is accurate.
12. Attach the required medical certification, which includes a statement from a licensed healthcare provider detailing the requested accommodations and medical need.
13. Once completed, submit the form and medical certification to Jeff Koweek, Director of Employee Entitlements, following the provided submission methods.

Complete your Wcpss Accommodation Form online today to ensure your needs are met.