Loading
Form preview picture

Get Reasonable Accommodation Form Housing

Household member fills-in pink areas. For Accessible Units Reasonable Accommodations and Structural Modifications DATE TO Verification Source s Name ADDRESS FROM Housing Specialist SUBJECT Disability Verify Need for Reasonable Accommodation HOUSEHOLD MEMBER S NAME The household member named above has applied for or is receiving federal rental assistance at our site. The household member has requested an accessible unit accommodation or modification to their unit. We are required to verify that the household member qualifies as disabled under federal law and requires what he or she has requested. We would appreciate your cooperation in answering the questions on this form and returning it to the Housing Specialist listed above. FORT COLLINS HOUSING AUTHORITY Reasonable Accommodation Verification Doctor / Verification Source fills-in yellow areas. Household member fills-in pink areas. For Accessible Units Reasonable Accommodations and Structural Modifications DATE TO Verification Source s Name ADDRESS FROM Housing Specialist SUBJECT Disability Verify Need for Reasonable Accommodation HOUSEHOLD MEMBER S NAME The household member named above has applied for or is receiving federal rental assistance at our site. The household member has requested an accessible unit accommodation or modification to their unit. We are required to verify that the household member qualifies as disabled under federal law and requires what he or she has requested* We would appreciate your cooperation in answering the questions on this form and returning it to the Housing Specialist listed above. --------------------------------------------------------------------------------------------------------------------- YOU DO NOT HAVE TO SIGN THIS FORM IF THE NAME OR ADDRESS OF EITHER THE HOUSING COORDINATOR OR THE VERIFICATION SOURCE IS LEFT BLANK. RELEASE I hereby authorize the release of the requested information* Signature Date 1 of 2 Updated 03/15/2011 /cg INFORMATION REQUESTED 1. Is the household member disabled as defined below Yes No Under federal law an individual is disabled if he/she has a physical or mental impairment that substantially limits one or more major life activities has a record of such impairment or is regarded as having such impairment. The term physical or mental impairment includes but is not limited to such diseases and conditions as orthopedic visual speech and hearing impairments cerebral palsy autism epilepsy muscular dystrophy multiple sclerosis cancer heart disease diabetes Human Immunodeficiency Virus infection mental retardation emotional illness drug addiction and alcoholism* This definition doesn t include any individual who is a drug addict is currently using illegal drugs or is an alcoholic who poses a direct threat to property or safety because of alcohol use. 2. Does the household member require what he/she has requested 3. Describe what the household member has requested how this request is related to their disability and describe any other accommodation or modification that could meet the household member s needs in place of what the household member has requested for example if there is a less expensive way to help the household member cope with his/her disability please disclose Name Title of Verification Source please print Firm/Organization Physician Identification Number if applicable 2 of 2.

How It Works

reasonable accommodation letter from doctor for housing template rating
4.8Satisfied
64 votes

Tips on how to fill out, edit and sign Accommodation form online

How to fill out and sign Reasonable accommodation form for housing online?

Get your online template and fill it in using progressive features. Enjoy smart fillable fields and interactivity. Follow the simple instructions below:

Getting a authorized specialist, making an appointment and going to the workplace for a private meeting makes finishing a Reasonable Accommodation Form Housing from start to finish tiring. US Legal Forms enables you to quickly create legally valid papers based on pre-constructed web-based blanks.

Perform your docs within a few minutes using our easy step-by-step guide:

  1. Get the Reasonable Accommodation Form Housing you require.
  2. Open it with online editor and begin adjusting.
  3. Complete the empty fields; engaged parties names, addresses and numbers etc.
  4. Customize the template with unique fillable areas.
  5. Put the date and place your e-signature.
  6. Click Done after double-checking everything.
  7. Download the ready-created papers to your gadget or print it out as a hard copy.

Swiftly create a Reasonable Accommodation Form Housing without needing to involve experts. There are already more than 3 million people taking advantage of our unique collection of legal forms. Join us today and get access to the #1 library of online templates. Try it out yourself!

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Reasonable accommodation form template FAQ

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.

Keywords relevant to ada form for doctor

  • ada form
  • accommodation template
  • CG
  • applicable
  • retardation
  • doesnt
  • Orthopedic
  • palsy
  • substantially
  • autism
  • modifications
  • modification
  • alcoholism
  • verification
  • accommodation
If you believe that this page should be taken down, please follow our DMCA take down processhere.
Ensure the security of your data and transactions

USLegal fulfills industry-leading security and compliance standards.

  • 
                            VeriSign logo picture

    VeriSign secured

    #1 Internet-trusted security seal. Ensures that a website is free of malware attacks.

  • Accredited Business

    Guarantees that a business meets BBB accreditation standards in the US and Canada.

  • 
                            TopTenReviews logo picture

    TopTen Reviews

    Highest customer reviews on one of the most highly-trusted product review platforms.