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Ergonomic Request Tracker

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Ergonomic Request Tracker

Managing ergonomic requests for your organization
Ergonomic equipment requests are a frequent job accommodation request HR professionals receive. It’s important to have a process to manage these requests for compliance purposes but will also make for a better employee experience in receiving detailed, consistent, and timely communication.
This document provides a comprehensive request tracker, pre-configured to easily send out communications and track relevant notes and case status.
Ready to get started??
Clear Sample Data
Questions? Email
@Lucy Yip

Start here to customize this document for your organization’s needs

Modify the email templates under
Determine deadline for when you’d like your health form returned. This template currently uses a formula of 10 days from Request Date. Edit calculation if you’d like that formula changed.
Screenshot 2023-12-22 at 3.50.00 PM.png
Screenshot 2023-12-22 at 3.50.07 PM.png

Now that you’ve configured your template, you’re ready to start processing your first Ergo request!

Instructions for User

Add New Ergo Request
New Ergo Request
Add name and email.
If employees are added to your Coda workspace, you can update the column to people and modify the email column to automatically pull their email-address.
Indicate Request Date. This determines the Health Form Deadline
Ergonomic Request Intake is auto-selected as your default email for your new request. Hit button Send Email
Employee should return the completed health provider form. Upload this to Record Keeping File
Evaluate your employee’s request. If approved, select “Ergonomic Request Approved” under Email Subject and hit button Send Email
As you interact with your employee, it’s recommended to keep notes for any accommodation cases. Note dates and key events under notes
💥 using this emoji will highlight under Summary Notes
Coordinate your equipment to be sent to employee. When finished with your Accommodations case, mark Request Complete
Ergo Requests Tracker
Request Date
Health Form Deadline
Email Subject
Email Body
Send Email Button
Sally Glasgow
Ergonomic Request Intake
Hi Sally,
Thank you for inquiring about ergonomic equipment. Before a decision can be made regarding your request we need additional information from your Health Care Provider. As such, please schedule an appointment with your provider and request that they complete the Certification of Health Care Provider form, found here. Please submit the completed form within 10 calendar days from today (by 12/28/2023). If this date falls on a weekend or holiday, please provide the following business day.
When completing the Health Care Provider form, please have your provider be as specific as possible and include recommendations for specific ergonomic equipment that would best support your situation.
Once the medical questionnaire form is received back, we will review it and determine what additional steps are needed. Please be assured your medical information will remain confidential and shared only with those on a need to know basis.
Let me know if you have any other questions in the meantime.
Send Email
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Summary Ergo Requests
Request Complete
Request Date
Record Keeping File
Summary Notes
Request Complete
Request Completed On
Sally Glasgow
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