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Religious Accommodation Request Form Template

Streamline religious accommodation requests for easier approval

Submitting a religious accommodation request can be daunting, especially when clarity is key. This template helps employers manage requests efficiently while ensuring employees feel heard and respected. You can simplify communication, maintain compliance with legal standards, foster an inclusive workplace, and protect employee rights-all in one easy-to-use format. Explore how this template can enhance your process today.

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Full name
Work email
Phone number
Department or team
Job title or role
Supervisor or manager name
Is this request based on a sincerely held religious belief or practice?
Yes
No
Type of accommodation requested
Schedule change or shift swap
Time off for religious observance
Regular prayer breaks
Quiet space for prayer/meditation
Dress or grooming modification
Exemption from specific task or activity
Dietary accommodation
Alternative scheduling for trainings/meetings
Other
Please Specify:
Describe the accommodation you are requesting
Briefly explain how your religious belief or practice relates to this request
Requested start date
Is the accommodation temporary or ongoing?
Temporary
Ongoing
Not sure
Describe any acceptable alternatives that would also meet your religious needs (if any)
Can you perform the essential functions of your job with this accommodation?
Yes
No
Do you have supporting documentation you wish to provide to HR (e.g., schedule of observances)?
Yes
No
Type your full name to sign
Date signed
I certify that the information provided is accurate to the best of my knowledge.
Strongly disagree
Disagree
Neither
Agree
Strongly agree
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Paper art illustration depicting a religious accommodation request form for FormCreatorAI article.

When to use this form

Use this form when you need a workplace or school adjustment for a sincerely held religious belief or practice. Common requests include schedule changes for prayer, time off for holy days, space for observance, or exceptions to dress or grooming rules. HR, managers, and administrators benefit from clear details that help them respond quickly and consistently. You get a documented decision and a record for future planning. If your request also involves time away, pair it with the Vacation and sick leave form or the Absence request form to track hours accurately.

Must Ask Religious Accommodation Request Questions

  1. What religious belief, observance, or practice is involved?

    This clarifies the sincere belief at issue and helps reviewers avoid assumptions. Being specific makes it easier to match an accommodation to your actual practice.

  2. What accommodation do you need, and for which dates, times, or frequency?

    Dates and frequency define the scope, so scheduling and coverage can be planned. If you need a specific holy day off, you can pair this submission with the Holiday application form.

  3. How does the current policy, schedule, or requirement conflict with your practice?

    This pinpoints the exact rule or task that creates a conflict. When reviewers know the barrier, they can adjust that piece rather than overcorrect.

  4. What alternative accommodations would also meet your needs?

    Offering options shows flexibility and may reduce impact on operations. It increases the chance of a timely yes while still meeting your needs.

  5. Have you received this accommodation before, and what was the outcome?

    Past outcomes show what worked and what did not, saving time. It also builds a record that supports consistent, fair decisions.

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