Reasonable Accommodations Request Form
If you have a physical or mental health problem or disability, and you need a physical change to your housing unit, a change in our policies, or a change in the way we communicate with you, you may ask for this kind of change, which is called a Reasonable Accommodation. If you can show that you have a disability or health problem that interferes with your use of housing, and if your request is reasonable, we will try to make the changes you request. You can ask for this change by filling out this form or contacting the Property Manager. Our team can assist you in filling out a Reasonable Accommodation Request Form. We will give you an answer within 14 days, unless there is a problem obtaining the information we need, or unless you agree to a longer timeframe. We will let you know if we need more information or verification from you or if we would like to talk with you about other ways to meet your needs. If we turn down your request, we will explain the reasons in writing, and you can give us more information if you think that will help. All information you provide will be kept confidential and be used only to help you have an equal opportunity to enjoy the housing.
Date of request:
*
-
Month
-
Day
Year
Date
Name of person making the request
*
First Name
Last Name
Is this Resident/Applicant:
Yes
No
Relation to the Resident:
social worker, family member, friend, representative
Contact information for Requestor
if different than resident/ applicant
Requestor Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Requestor Email
example@example.com
Resident Name
*
First Name
Last Name
Resident Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Resident Email
*
example@example.com
What type of reasonable accommodation or modification are you requesting
*
Modification to our policy (pet policy, payment timing, eviction filing, etc)
Modification to the property(Grab bars, Hand rails, Wheelchair ramps,etc)
Description of Improvement to be completed
Location of Improvement
Materials Planned for Improvement
Include any documentation, sketches, or illustrations related to the requested modification.
Browse Files
Drag and drop files here
Choose a file
Photo of safety rail, Picture of ramp, Hospital documentation, etc.
Cancel
of
Who will perform this improvement?
Tenant
Contractor
Contractor name(s):
Contractor phone number:
Please enter a valid phone number.
Format: (000) 000-0000.
Is the Contractor Licensed?
Yes, Licensed in South Carolina:
No: Not Licensed
License#
Proposed Start Date
-
Month
-
Day
Year
Date
Proposed Finish Date
-
Month
-
Day
Year
Date
Estimated Cost of Improvement
Describe the reasonable accommodation request:
*
Signature of Requester:
*
Submit
Should be Empty: