System Offices Request for Reasonable Accommodation Based on Medical Condition or Religious Exemption

Complete this form to request an ADA accommodation or a COVID vaccination exemption for a medical condition or religious reason. This form is to be used by System Office employees only.

To complete the reasonable accommodation request form paperless and online, please use the following link:
Reasonable Accommodation Medical Condition Form
 

If you would prefer to fill out, print, and manually route your form, please use the following link:
Reasonable Accommodation Medical Condition Form