Sample Reasonable Accommodation or Modification Request Form
The forms provided by the Housing Equality Center on this website are samples intended to guide your drafting of a document meeting your specific situation and is not intended to be a substitute for professional legal assistance. Each situation is different and therefore these form letters can only serve as a guide to specific drafting by each user. All information in the form letters herein is provided in good faith, however we make no representation or warranty of any kind, express or implied, regarding the accuracy, adequacy, validity, reliability, availability or completeness of any form letter.
Under no circumstance shall we have any liability to you for any loss or damage of any kind incurred as a result of the use of one or more of the form letters herein or reliance on any information provided on any form. Your use of a form letter and your reliance on any information on a form letter is solely at your own risk which you expressly assume by downloading or otherwise use one or more form letters herein.
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Please fill out the form below to request help in requesting a reasonable accommodation or modification due to a disability-related need.
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