Lactation Accommodation Request

Lactation Accommodation Request

This HR form makes is clear that a request for workplace facilities for pumping breastmilk will be accommodated by an employer. The form has room to list details about privacy, milk storage, time, and electricity access, along with times of day the accommodations are likely to be needed.

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Description

Lactation Accommodation Request

Fields: Employee, Employee ID Number, Position, Department, Employee Status, Contact Information, Supervisor, Date, Employee Lactation Rights, Specific Room Request, Accommodations Request, Days of the Week Needed, Times of Day Needed, Signature and Date.

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