Reasonable Accommodation & Modification Request

BIRMINGHAM HOUSING

Reasonable Accommodation & Modification Request

Use this form to request a reasonable accommodation or modification. Fields marked with an asterisk, including Property Name, are required. You may provide your email address or phone number to help our team follow up.

Full name

Property Name

Enter the name of your housing community or property.

Home address

Include your community/property name and apartment or unit number, if applicable.

Date of request

Requested accommodation or modification

Briefly describe what you are requesting.

Name of qualified professional or licensed health-care professional

Provide a professional who can verify the disability and the need for the requested accommodation. For an assistance animal request, identify a licensed health-care professional. If you do not have this information yet, you can provide it during follow-up.

Professional’s address

Professional’s phone number

Your email address

Optional contact information to help our team follow up.

Your phone number

Optional contact information to help our team follow up.

After submitting, your property management office will follow up about any authorization needed to request verification from the professional you identified. You will be notified in writing when a decision is made.