ABC Business Request Form

Architectural Barriers Consultation

Request for Services
We have a reasonable cost per hour for business owners desiring to make their properties and/or establishment(s) more accessible to people with disabilities.

After you have submitted this request form, our Consultant will contact you within a few business days to discuss further details, application, and appointment for the consultation.

At this time services are for Dutchess County locations only.

Each question with a * must be answered.
Date of Request*

MonthDayYear
Date
This request form is for business owners only. If you are the homeowner/individual with the disability do not complete this form.*

I confirm I am the business owner requesting services for my own property
Your Name*

First NameLast Name
Email address*
example@example.com
Phone number*
Pronouns*
She/Her, They/Them, He/His...
Direct Ext*
Business Name & Address*

Business Name

Street Address Line 2

CityState / Province

Postal / Zip Code
What type of property is it?*

0/150
Briefly describe what is needed:*

Ramp, door ways widen for wheelchair, grab bars in bathroom, bathroom modification, rollin shower, parking, etc.0/150
If you have not received a call or email response within 10 business days, please contact: (845) 452-3913 ext.105 or L.Tarricone@taconicresources.org
Should be Empty:

Architectural Barriers Consultation