Accommodation and Modification Sample Letters
Templates for Tenants and for Medical and Service Providers.
Accommodation Request Template for Medical and Service Providers
Date
Name of Landlord or Management Company
Address
Email Address
RE: Tenant/Patient Name and Date of Birth
Dear [Name of Landlord or Management Company]:
My name is [name of provider], and I work as a [role] at [name of practice]. [Name of tenant/patient] has been my patient since [month/year services began]. [She/he/they] [has/have] a physical or mental disability, or both, that affects [her/his/their] ability to [insert area of impact, e.g., manage stress and anxiety].
[Name of tenant/patient] would benefit from [insert accommodation] because it will help [her/him/them] [insert how the accommodation will help, e.g., manage stress and cope with anxiety] more effectively.
Sincerely,
/s/ Signature of provider
Name of Provider
Name of Practice
Contact Information
Accommodation Request Template for Tenants
Date
Name of Landlord or Management Company
Address
Email Address
RE: Reasonable Accommodation Request for [Tenant Name]
Dear [Name of Landlord or Management Company]:
My name is [tenant name], and I am your tenant at [tenant address]. I am a person with a [physical/mental/both] disability and am writing to request a reasonable accommodation for my disability under the federal Fair Housing Act.
My [physical/mental] disability affects my ability to [describe area of impact, e.g., manage stress and anxiety or keep a clean and organized home]. My medical provider has advised me that [insert accommodation, e.g., having an assistance animal or live-in caregiver] would help me manage the symptoms of my disability more effectively. As a person with a disability, I am entitled to the rights and protections provided by the federal Fair Housing Act.
As an accommodation for my disability and under the federal Fair Housing Act, I request permission to [insert accommodation, e.g., obtain an assistance animal, have a live-in aide move in, or obtain a dedicated parking space].
Please respond in writing at your earliest convenience, but no later than one month from the date of this letter. If you have questions about this request or want to discuss it with me, contact me at [phone number] or [email address].
Sincerely,
/s/ Signature of tenant
Modification Request Template for Tenants
Date
Name of Landlord or Management Company
Address
Email Address
RE: Reasonable Modification Request for [Tenant Name]
Dear [Name of Landlord or Management Company]:
My name is [tenant name], and I am your tenant at [tenant address]. I am a person with a [physical/mental/both] disability and am writing to request a reasonable modification to my apartment under the federal Fair Housing Act.
My [physical/mental] disability affects my ability to [describe area of impact, e.g., safely use stairs or maintain balance while showering]. My medical provider has advised me that [insert modification, e.g., a ramp, chair lift, or grab bars] would help me safely use and enjoy my dwelling.
As a person with a disability, I am entitled to the rights and protections provided by the federal Fair Housing Act. Failure to permit a reasonable modification requested by a person with a disability may constitute prohibited discrimination under the federal Fair Housing Act.
I request permission to [insert modification] at [describe where the modification will be installed] as a reasonable modification.
Please respond in writing at your earliest convenience, but no later than one month from the date of this letter. If you have questions about this request or want to discuss it with me, contact me at [phone number] or [email address].
Sincerely,
/s/ Signature of tenant