This form should be completed by a Knox College employee who feels they are at increased risk for severe illness due to COVID-19 (or are caring for someone in their household that is at increased risk) and would like to request a reasonable workplace modification due to the COVID-19 pandemic. Reasonable workplace modifications will be considered based on CDC Guidelines and may include but not be limited to: a temporary remote work assignment, physical distancing (such as staggering shifts), alternative work locations, modified or flexible schedules and/or the use of personal leave, etc.
All approved COVID-19 reasonable workplace modifications will be evaluated every 30 days and may be cancelled by Knox College at its discretion based on guidance from any of the following: Center for Disease Control (CDC), Illinois Department of Public Health (IDPH), other governing bodies, or an employee's inability to perform the essential job functions of the position remotely (if a remote work arrangement is part of the reasonable accommodation). The Human Resources office, in conjunction with health care and personnel professionals, will determine what modification is reasonable after seeking input from you and your supervisor (Confidential medical information will not be shared outside of Human Resources).
The requesting employee will need to provide a statement of how they will perform their essential job functions while working under the approved modifications and medical documentation from their physician.
An interactive discussion will occur with the employee, employee's supervisor and Human Resources once the required documentation is received. The reasonable modification is not approved until the empoloyee has received official notification from Human Resources.