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Applicant Name
Please detail the accomodation
Please describe the nature of the impairment and if you require any specialist equipment
Click or drag a file to this area to upload.
Clear Signature

Use our reasonable accommodation request form to allow an individual to request an accommodation due to a disability. The form provides someone with a medical impairment or disability to ask for housing under the ADA (Americans with Disabilities Act of 1990).

 Check out the reasonable accommodation request form below:

What Does Our Form Include?

The purpose of the reasonable accommodation request form is to allow individuals to request housing. In our template, we’ve included:

  • A personal information section.
  • Details about the individual and their accommodation request.
  • An E-signature section to make the form official.

The beauty of WPForms templates is that they’re fully customizable. If you require more detail about the individual, ask for their current address, create a dropdown of the available accommodations in specific areas, or add a terms and conditions agreement field.