REASONABLE ACCOMMODATION/MODIFICATION REQUEST VERIFICATION 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the date at the top of the form. This helps establish a timeline for your request.
3. Fill in the Health Care Provider’s name and address. This information is crucial for verifying the resident's disability status.
4. Next, provide the Owner’s name and address. This identifies who will receive the completed verification.
5. In the section labeled 'REQUEST FOR REASONABLE ACCOMMODATION/MODIFICATION', enter the resident's name and address to specify who is requesting assistance.
6. Respond to each question regarding the resident's disability status and need for accommodation by selecting 'Yes' or 'No'. Be sure to provide explanations where necessary.
7. Complete any additional questions about alternative accommodations or contact availability, ensuring all fields are filled accurately.
8. Finally, have the health care provider sign and date the form, confirming their responses before submitting it back to the owner.

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