Workplace Adjustment Request Template

Equipping employees with the tools needed to do their job optimally

Written By Charles Kransberger (Administrator)

Updated at February 6th, 2025

What

This fillable template, completed by employees, communicates an informal request for a workplace adjustment or neuroinclusive best practice to their manager.

 
 

Who

Employees are responsible for filling out the template and submitting it to their manager. 

 
 

Why

Knowing how to phrase support requests can be difficult. This template will help structure your request clearly and professionally.

 
 

How

The employee fills out the template message with person- and context-specific information about their support needs and then sends the request to their manager. Available workplace adjustments are expected to be communicated to both parties beforehand to promote a streamlined, transparent process with alignment between parties. 

 
 

Case Study

Insert story about one of our program hires benefitting from workplace adjustments. 

Bottom Line Benefits

Describe how the implementation of workplace adjustments benefitted their business (individual, team, and/or organizational benefits)


https://static.helpjuice.com/helpjuice_production/uploads/upload/image/18849/4054378/Workplace_Adjustments_Request_Template__1_.docx

 

ND Community/Research Highlights

[link to external blogs/resources that amplify ND & intersectional voices]

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