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Company Name] ’s COVID-19 Vaccination Policy.Please briefly explain how your sincerely held religious belief, observance, or practice conflicts with ’s COVID-19 Vaccination Policy.Do you regard yourself as having a sincerely held religious belief, observance, or practice that you believe should exempt you from ’s COVID-19 Vaccination Policy? YES NO.Part 1 - To be completed by employee requesting accommodation If you have any questions about an accommodation or exemption request you made, please contact in the Human Resources Department. strives to make these determinations expeditiously and in a fair and nondiscriminatory manner and will inform you after we make a determination. makes determinations about requested accommodations and exemptions on a case-by-case basis, considering various factors and based on an individualized assessment in each situation. Refusing to provide the information requested in this form may impact ’s ability to adequately understand your request or effectively engage in the interactive process to identify possible accommodations.
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This information will be used by Human Resources or other appropriate personnel to engage in an interactive process to determine the precise limitations of your ability to comply with ’s COVID-19 Vaccination Policy and explore potential reasonable accommodations that could overcome those limitations. To request an accommodation related to ’s COVID-19 Vaccination Policy, please complete this form and return it to Human Resources. will provide reasonable accommodations for employees’ sincerely held religious beliefs, observances, and practices that conflict with getting vaccinated for COVID-19, as long as the requested accommodation does not create an undue hardship for or pose a direct threat to you or others in the workplace.
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As such, complies with all laws protecting employees’ religious beliefs and practices. Is committed to providing equal employment opportunities without regard to any protected status, and a work environment that is free of unlawful harassment, discrimination, and retaliation.