Request for Reasonable Accommodation Form
This form is designed for individuals with disabilities seeking housing assistance. It allows applicants to request necessary accommodations to ensure equal access to housing services. Completing the form accurately helps DHA assess and support accommodation needs.
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How do I fill this out?
To fill out this form, start by providing your personal information and the details of the accommodation needed. Ensure that you include the names and relationships of anyone assisting you in filling out the request. If necessary, obtain verification from a medical professional regarding your disability.

How to fill out the Request for Reasonable Accommodation Form?
1
Gather personal information and details of your disability.
2
Complete sections regarding individual accommodation requests.
3
Provide information about any live-in aide if applicable.
4
Include contact details for a medical professional for verification.
5
Sign and date the form before submission.
Who needs the Request for Reasonable Accommodation Form?
1
Individuals with disabilities seeking housing assistance.
2
Caregivers of disabled individuals needing accommodations.
3
Parents or guardians filling out requests for minors.
4
Social workers assisting disabled clients with housing applications.
5
Advocates working with disabled individuals to access services.
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What are the instructions for submitting this form?
To submit this form, you can either email it to 504/ADA@dhadal.com or fax it to 214-951-8300. You may also choose to deliver it in person to the DHA office at 3939 North Hampton Rd, Dallas, TX 75212. Make sure to keep a copy of your submission for your records as a reference.
What are the important dates for this form in 2024 and 2025?
Important dates regarding the form will be announced in 2024 and 2025. Please check back for updates on deadlines for submissions and any relevant changes to policies. Keeping track of these dates ensures timely processing of your request for accommodations.

What is the purpose of this form?
The purpose of this form is to facilitate individuals with disabilities in accessing housing supports they need. By submitting this request, applicants can ensure that their specific accommodation needs are officially recognized and considered. The form serves as an essential tool for both applicants and DHA in the housing process.

Tell me about this form and its components and fields line-by-line.

- 1. Head of Household Name: The name of the individual applying for assistance.
- 2. Date of Request: The date on which the request is being submitted.
- 3. Accommodation Details: Specific details about the accommodation required due to the disability.
- 4. Medical Professional Information: Contact information of a professional who can verify the disability.
- 5. Signature: The applicant's signature authorizing the request.
What happens if I fail to submit this form?
Failing to submit this form can result in denial of requested accommodations. Without the form, DHA may not recognize the accommodation needs for individuals with disabilities, leading to unequal access to housing. It is crucial to complete and submit this form timely to ensure compliance with fair housing laws.
- Delayed Processing: Submitting without proper information may delay the processing of your request.
- Denial of Accommodations: Without the form, your request for necessary accommodations may be denied.
- Lack of Support Services: Failure to submit may mean missing out on vital support services.
How do I know when to use this form?

- 1. New Housing Applications: Use this when applying for new housing assistance.
- 2. Current Program Participation: Required for existing participants who need accommodations.
- 3. Live-In Aide Requests: Necessary for those seeking a live-in aide as part of their accommodations.
Frequently Asked Questions
Who should fill out this form?
This form should be filled out by individuals with disabilities seeking housing accommodations.
Is assistance available for completing the form?
Yes, you can ask a DHA staff member for help if needed.
What information is required for verification?
You need to provide a doctor’s name and contact information for disability verification.
What if I need a live-in aide?
You must provide specific details about your prospective live-in aide in the form.
Can I submit this form online?
Yes, you can fill out and submit the form online through the specified channels.
How is the information in this form used?
The information is used to determine necessary accommodations for housing.
What happens if I don't fill out all the sections?
Incomplete forms may delay the processing of your accommodation request.
How do I know if my request for accommodation is approved?
DHA will contact you with information regarding the status of your request.
Can I update my request after submission?
Yes, you can contact DHA to make updates to your accommodation request.
What should I do if I experience issues with the form?
Reach out to DHA support for assistance in resolving any issues.
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