Get Hra Reasonable Accommodation Request Form

This guide provides clear and supportive instructions on how to complete the HRA Reasonable Accommodation Request Form online. The purpose of the form is to request reasonable accommodations for individuals with disabilities, ensuring meaningful access to HRA programs and services.

Follow the steps to complete your accommodation request form online.

1. Click ‘Get Form’ button to access the HRA Reasonable Accommodation Request Form and open it in your preferred online editor.
2. Begin by entering your personal information in the designated fields, including your name, case number (if known), social security number (if known), telephone number, mailing address, center number (if known), and HRA program name (if known).
3. Respond to the eligibility questions provided in the form. Indicate whether you have been evaluated by HRA’s WeCARE program, if an application for supportive housing has been submitted, if you receive federal disability benefits, and if you require home care services.
4. Describe your medical or mental health condition in detail. Clearly state the reasonable accommodation you are requesting and explain why you need it. You may attach additional sheets or any relevant medical information to support your request.
5. Provide your signature and date to confirm your submission. If applicable, include your authorized representative’s signature and their printed name.
6. Once you have filled in all required fields, ensure that you save your changes. You can then download, print, or share the completed form as needed.

Take the important step of submitting your request by completing the HRA Reasonable Accommodation Request Form online today.