Request for a Reasonable Accommodation

If a household member has a disability, you can ask SHA for a change in a rule, policy, practice or service, or a change to your unit or the property, so they can use and enjoy their housing like anyone else. This is called a reasonable accommodation.

You do not have to use this form. You can also ask any staff member in person, by phone, or in writing.
The information is kept completely confidential and used only to decide on your request.
Eric Ross, Executive Director, can be contacted about reasonable accommodations. If you have any questions, call the office at 903-893-3139 or contact Relay Texas at 1-800-735-2989.

About the household

Head of household

Phone

Requestor (the person making this request)

Address

Email (optional)

1. Household member with a disability

The name of the household member with a disability who needs a reasonable accommodation. (A physical or mental impairment that substantially limits one or more life activities; or a record of having such an impairment, or regarded as having such an impairment.)

Name

2. Kind of change needed

Because of the above household member's disability, the following change(s) or assistance (reasonable accommodation) is necessary so that the individual can participate in the Sherman Housing Authority's (SHA) public housing program as easily or successfully as other program participants. Check the kind of change(s) you need.

A change or special feature in a dwelling, building, or property. Assistance with, or change in SHA practice, rule, policy, procedure, program or service. (Note that a change in how to meet the terms of the lease may be requested, but the terms of the lease must be met.) Other. (For example, a change in the way SHA communicates with you.)

3–5. The request

3. Describe the problem that the household member named in Item 1 is having, or might have, with a SHA dwelling, building, property, practice, rule, policy, procedure, program or service.

4. Describe the type of change or assistance (reasonable accommodation) required.

5. Describe how this change or assistance will help with the problem.

6. Verification source

The verification source SHA may contact to verify that the household member named in Item 1 has a disability and needs a reasonable accommodation.

Name of health care provider / documenting authority

Title

Agency, facility, or institution (if applicable)

Address

Phone

I understand that the information obtained by the SHA will be kept completely confidential and used solely to make a determination on my reasonable accommodation request. I am signing this request. My typed name as Requestor above is my signature.

This goes only to the SHA staff who handle it. See our Privacy Notice.

Sherman Housing Authority does not discriminate on the basis of race, color, religion, sex, age, disability, familial status, or national origin or on the basis of disability status in the admission, or access to, or treatment or employment in, its Federally assisted programs and activities.

Request for a Reasonable Accommodation

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