June 12, 2026

To whom it may concern:

Subject: Request for pregnancy work accommodation

My name is [name]. 

What I am requesting:

Reasonable accommodation: limit lifting to 20 lb, additional bathroom breaks, ability to sit/stand as needed, 10-minute rest break each 2 hours.

This request is supported by my prenatal care provider at Materna Health Solutions. I am available to answer questions or to coordinate with your team.

Thank you,

[name]