Request for Temporary Modified Work Arrangement - Medical Reasons

During the COVID-19 pandemic, you may request an accommodation for a temporary modified work arrangement. Human Resources will review your request.

• Submit a Request for Temporary Modified Work Arrangement - Medical Reasons
• Submit a Medical Certification Request

The forms on this page are for medical reasons only. For non-medical requests, please use the Staff Temporary Flexible Work Agreement Form. If currently working remotely, you do not need to complete this form until your return to campus date has been established by your supervisor.