Restroom Use Hardship Letter

{Name}
{Address}
{Phone #}

{Date}

Dear {supervisor}:

I must respectfully inform you that I require an exception to the company's restroom usage policy. Due to {medical condition}, I need to relieve myself {frequency}. This doesn't mesh with the stated policy that employees may only step away from their work stations {frequency/period of time}.

Thank you in advance for accommodating this basic human need. Reasonable restroom access is also assured by the Occupational Safety and Health Administration (OSHA). Specifically in reference to my medical condition, I have attached a note from my physician, Dr. {Name}.

Sincerely,

{Sender Name}

attached: note from Dr. {Name}.

Index of Hardship Letter Examples