Request Accommodations

In order to ensure access to all City programs, services, and activities, the City will provide translations, will reasonably modify its policies and procedures, and will provide auxiliary aids and alternative formats to persons with disabilities at no charge.

Persons with disabilities who need auxiliary aids and services for effective communication, written materials in alternative formats, or reasonable modifications in policies and procedures in order to access the programs, services, and activities of the City of Somerville should directly contact the ADA Coordinator no later than seven (7) business days before the scheduled event.

Event Name*

If you would like to request accommodations for a specific event, please enter the name of the event here.

Name*

First NameLast Name

Event Date

If you would like to request accommodations for a specific event, please enter the date of the event here.

Type of Assistance Required*

How can we help to accommodate you?

Your Contact Information*

Please provide a phone number or email address where we can reach you.

How would you like us to contact you to arrange the accommodations? Check all that apply.*

EmailPhone

Email*

PLEASE NOTE: If we don't have working contact information, we will not be able to assist. Please double-check the accuracy of your information when submitting.

Phone Number*

PLEASE NOTE: If we don't have working contact information, we will not be able to assist. Please double-check the accuracy of your information when submitting.