Housing request reasonable accommodation sample 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your name, phone number, and address in the designated fields. This information is essential for identifying your request.
  3. In the section labeled 'The following member of my household has a disability,' provide the name of the individual with a disability. Ensure accuracy as this is crucial for processing your request.
  4. Clearly state your accommodation request in the provided space. Be specific about what you are asking for to facilitate understanding and approval.
  5. Explain how this accommodation will enable you to fully participate in the housing program. This helps convey the importance of your request.
  6. Sign and date the form at the bottom, acknowledging that you understand your current lease obligations and that this request is an exception to policy.
  7. Complete the Release of Information section by filling out your client name, verifying party details, and signing to authorize communication regarding your accommodation needs.
  8. Finally, submit the completed form to your Property Manager or Boulder Housing Partners as instructed.

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Permitting a tenant to transfer to a ground-floor unit or to another unit that meets a tenants disability-related needs. Adjusting a rent payment schedule to accommodate when an individual receives income assistance. Permitting an applicant to submit a housing application via a different means.
ACCOMMODATION(S) REQUESTED (Be as specific as possible, for example adaptive equipment, reader, interpreter, training, schedule change, etc.): REASON FOR REQUEST (Please do not disclose your diagnosis; explain your disability-related limitations and how this accommodation will help you do your job.)
Reasonable accommodation can include, but is not limited to, the following: Changing job duties. Providing leave for medical care. Changing work schedules. Relocating the work area. Providing mechanical or electrical aids.