Workplace Accommodation Request Form
Request workplace adjustments using functional needs, preferred outcomes, repeatable options, timing, optional documents, and contact consent.
Preview
Interact with the actual form experience before opening the template in Formspace. Responses entered here are not saved.
What's included
A quick static summary of the main sections and fields, so visitors can scan the structure before opening the full template.
Employee and contact preferences
Provide the details needed for a confidential workplace conversation.
Employee name, Work email, Department or team, Preferred contact method, plus 1 more.
Functional needs and timing
Describe the workplace barriers and when support is needed.
Areas where a workplace barrier is occurring, Describe the workplace barrier and its practical impact, Expected duration, Requested start date, plus 1 more.
Adjustment options and consent
Describe possible supports and add only documents relevant to the request.
Adjustment area, Requested adjustment or option, What outcome would this support?, Optional supporting information relevant to the request, plus 3 more.
How to use this template
When to use it
Use this template when you need a structured hr workflow for Human resources, Workplace operations, Professional services teams. It works best when the response needs enough context for a reviewer to take the next step without sending several follow-up messages.
How to customize it
- Replace generic labels with language your respondents already use.
- Move optional questions later in the form so the first page stays easy to complete.
- Add internal routing notes or tags if different team members handle different response types.
- Explain exactly which files are useful so respondents do not upload unnecessary documents.
Example questions
Scan the questions and field types included in the template at a glance.
Employee name
Work email
Department or team
Preferred contact method
Phone number
Areas where a workplace barrier is occurring
Describe the workplace barrier and its practical impact
Expected duration
Requested start date
Questions about this template
What is the workplace accommodation request form template for?
A respectful workplace-adjustment request focused on barriers and practical support rather than requiring unnecessary diagnosis or medical detail. It is a good fit for Human resources, Workplace operations, Professional services teams that need a structured hr workflow.
Can I customize this workplace accommodation request form template?
Yes. Open it in Formspace to edit questions, pages, logic, branding, publishing settings, notifications, and response handling before sharing it.
What questions are included?
The template includes 17 questions across 3 sections. Example questions include: Employee name; Work email; Department or team; Preferred contact method.