NYC Homeless Services Reasonable Accommodation Form
This form is designed for clients seeking reasonable accommodations due to medical reasons. It guides users through the submission process to ensure their requests are properly documented. Completing this form is a crucial step in advocating for necessary adjustments.
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How do I fill this out?
To fill out the Reasonable Accommodation Request Form, start by completing Section I with your personal details and accommodation request. Ensure that you gather and include any necessary medical documentation that supports your request. Once completed, submit the form to the appropriate director as instructed.
How to fill out the NYC Homeless Services Reasonable Accommodation Form?
1
Complete Section I with personal and accommodation details.
2
Attach all required supporting medical documentation.
3
Submit the form to the designated Director.
4
Ensure a copy is returned to you after submission.
5
Follow up to confirm the request has been transmitted.
Who needs the NYC Homeless Services Reasonable Accommodation Form?
1
Clients experiencing homelessness needing support.
2
Individuals with medical conditions requiring special accommodations.
3
Service providers looking to assist clients effectively.
4
Social workers advocating for client needs.
5
Family members helping clients navigate the process.
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What are the instructions for submitting this form?
To submit the Reasonable Accommodation Request Form, fax the completed document to the Office of Diversity & Equal Opportunity Affairs at 212-361-7912. You should also email the form along with your supporting documents to eoa@dhs.nyc.gov. For physical submissions, send them to the Department of Homeless Services, 33 Beaver Street, New York, NY 10004.
What are the important dates for this form in 2024 and 2025?
Ensure you submit your accommodation requests promptly, especially if seeking assistance for specific events or changes in your situation in 2024 and 2025. Check for any deadlines set by the Department of Homeless Services for timely processing of requests.
What is the purpose of this form?
The purpose of this form is to request reasonable accommodations for individuals experiencing homelessness due to medical conditions. Completing this request helps secure necessary adjustments in housing or services based on medical documentation. It serves to facilitate an effective communication process between clients and service providers.
Tell me about this form and its components and fields line-by-line.
- 1. Client Information: Details about the client including name, address, and contact information.
- 2. Accommodation Request: Description of the specific accommodation being requested along with supporting documentation.
- 3. Director's Section: Section for the Director to complete after receiving the client's request.
- 4. Program Administrator's Feedback: Documentation of the review process by the Program Administrator.
What happens if I fail to submit this form?
Failing to submit this form can result in delays in receiving necessary accommodations. The request may not be processed, leaving clients without required support. It's crucial to submit promptly to avoid complications in assistance.
- Delayed Support: Failure to submit may lead to delays in receiving necessary accommodations.
- Lack of Communication: Without the form, the Director may not be aware of your needs.
- Process Inefficiencies: Not submitting can hinder the overall review process for accommodations.
How do I know when to use this form?
- 1. Medical Accommodations: For clients needing adjustments based on prescribed medical conditions.
- 2. Facility Requests: Used when requesting special access or support in a service facility.
- 3. Program Adjustments: Helpful for clients looking to change the terms of their service programs.
Frequently Asked Question
How do I start filling out the form?
Begin by downloading the PDF and filling in your personal details in Section I.
What should I attach to my form?
Ensure to include any relevant medical documentation that supports your accommodation request.
Who do I submit this form to?
Submit the completed form to the designated Program/Facility Director.
Can I edit this form after I fill it out?
Yes, you can easily edit the form using PrintFriendly's editing tools.
Is there a limit to the number of pages for supporting documents?
No, you can attach multiple pages as needed for your documentation.
How long does the submission process take?
The submission process depends on the review by the Program Administrator but typically takes a few days.
Can I share a link to my PDF?
Yes, you can share the PDF link via email or social media directly from PrintFriendly.
What if I need to make changes after submitting?
You will need to contact the Director to request changes to your submission.
How do I ensure my form is received?
Make sure to fax the form to the designated number and follow up with the office.
What's the next step after submitting the form?
You should receive a copy and confirmation from the Director's office.
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