Religious Accommodation Request Form

It is Mueller Family McDonald's intention to provide all employees with the help they need to be successful on the job. If you require a religious accommodation, please complete the form below. Someone from Human Resources will contact you to set up a meeting to review your request within 5 business days of receiving this form.

Please select

Employee First / Last name

Email address

Phone number

Requested accommodation (job change, schedule change, dress/appearance code exception, vaccination exemption, etc.):

Describe the religious belief or practice that necessitates this request for accommodation:

Length of time requested accommodation is needed:

Please provide your best guess as to how long you will need this accommodation: ie; 2 weeks, 1 month, indefinitely

Describe any alternate accommodations that might address your needs:

I have read and understand Mueller Family McDonald's policy on religious accommodation. My religious beliefs and practices, which result in this request for a religious accommodation, are sincerely held. I understand that the accommodation requested above may not be granted but that the company will attempt to provide a reasonable accommodation that does not create an undue hardship on the company. I understand that Mueller Family McDonald's may need to obtain supporting documentation regarding my religious practice and beliefs to further evaluate my request for a religious accommodation.

Verification