Americans with Disabilities Act (ADA) Request

Name

Address

City

State

Zipcode

Phone

Are you a City Employee seeking a workplace accommodation?

If so, please provide City department and position.

Please describe the access barrier or limitation you observed or encountered.

Location(s) of access barrier(s).

What was the first date this access barrier was encountered?

What is the earliest date resolution is required?

Please describe how you believe the City can remove the barrier or improve access

Please provide the names of any persons, or attach any documents, that can provide additional information regarding this concern.

Choose file

How may we best contact you?

Mobile 311