ReasonableAccommodation_Request

ADA / Reasonable Accommodation / Modification Request

For Spartanburg Housing to evaluate your request for a Reasonable Accommodation, we require specific information, which is required to establish the nature of the accommodation you are requesting, and its relationship to your disability. If your disability is not readily apparent, and we have not previously verified your disability, we will need to obtain verification from a 3rd party. This will be done using a standard verification form that will be sent to a licensed medical practitioner, or any other agency that you designate.

The Fair Housing Authority Act defines disability as a physical or mental impairment that substantially limits one or more major life activity. The Supreme Court has determined that to meet this definition, a person must have an impairment that prevents, or severely restricts, you from doing activities that are necessary in most people's activities of daily living.

[{"type":"checkbox-group","required":true,"label":"Do you consider yourself disabled? ","description":"Select Yes or No","inline":true,"name":"Disabled-","className":"d-block","values":[{"label":"Yes","value":""},{"label":"No","value":""}]},{"type":"checkbox-group","required":true,"label":"We need to know the type of accommodation your are requesting. Does your request concern any of the following? Please check all that apply: ","description":"Select what is applicable, you may select more than one. If \"Other\" is selected, please list the type of accommodation requested.","inline":true,"name":"Type-of-accommodation-request-","other":true,"className":"d-block","values":[{"label":"Physical modification to your home","value":"option-1"},{"label":"Transfer to a different unit","value":""},{"label":"Barrier-free (wheel chair accessible)","value":""},{"label":"Provision of your lease","value":""},{"label":"Unit adapted for sensory impairment ","value":""},{"label":"Rules, policies, practices or services","value":""},{"label":"Addition of a Live-in Aid (Restrictions apply)","value":""},{"label":"Companion or Service Animal ","value":""}]},{"type":"textarea","required":true,"label":"<span style=\"color: rgb(0, 0, 0); font-family: Georgia; font-size: medium;\">We do not need to know, and you are not required to disclose your disability. However, we do need to understand how the requested accommodation will allow you to continue to live in your apartment and enjoy your apartment community. Please describe how these changes will affect your activities of daily living: </span>","description":"Please describe how these changes will affect your activities of daily living.","placeholder":"Type your answer here","name":"Answer","subtype":"textarea","rows":5,"className":"d-block"},{"type":"textarea","required":true,"label":"<p style=\"color: rgb(0, 0, 0); font-family: Georgia; font-size: medium;\">Who can we contact to verify the need for this accommodation? (The person/agency must be able to directly address the limitation, caused by the disability.) List Physician or Agency:</p>","description":"List Physician or Agency:","placeholder":"Physician or agency name, address, and phone number","name":"Accommodation-verification","subtype":"textarea","rows":3,"className":"d-block"},{"type":"text","required":true,"label":"Your Current Address: ","description":"List your current address","placeholder":"Street, City, State, Zip Code","name":"Your-current-address","className":"d-block","subtype":"text"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"paragraph","subtype":"p","label":"RELEASE: In accordance with HIPPA requirements, I hereby authorize the release of the requested information for verification of the need and appropriateness of the accommodation requested: ","className":"d-block"},{"type":"text","required":true,"label":"Signature","description":"Type your full name","placeholder":"Full name","name":"Signature","className":"col-md-6","subtype":"text"},{"type":"date","required":true,"label":"Date Submitted","description":"Enter date form is submitted","name":"Submission-date-","className":"col-md-6"},{"type":"paragraph","subtype":"p","label":"<div class=\"clear\"></div>","className":"d-block"},{"type":"paragraph","subtype":"p","label":"<span style=\"color: rgb(0, 0, 0); font-family: Georgia; font-size: medium;\">Each request is evaluated on its own merit and the ability of Management to provide the accommodation at the time of the request. To the greatest extent feasible, Spartanburg Housing wants to assist individuals requesting a Reasonable Accommodation. We reserve the right to deny a request should it be established to be physically infeasible, an administrative or financial burden, or a fundamental change in the nature of the program. We reserve the right to propose an alternative accommodation to the one requested.</span>","className":"d-block"},{"type":"paragraph","subtype":"p","label":"<div class=\"clear\"></div>","className":"d-block"}]

ReasonableAccommodation_Request

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