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Reasonable Accommodation Form

This form should be used by clients to request reasonable accommodation for their disability so that they can participate in BRHP activities and access housing.
  • Disabled clients can expect reasonable accommodations that help them to have an equal chance to take part in the Baltimore Housing Mobility Program or to access housing. The accommodation(s) must directly relate to the person’s disability.

    You are not required to use this form. The Program will consider spoken or other written requests. However, it is best to document the request in writing.

    Before approving a request, the Baltimore Regional Housing Partnership (BRHP) must verify that the person meets the definition of disabled under the Fair Housing Act and that the request will improve the person’s access to BRHP’s program and services. Other documentation may be required to process the request.

  • The Baltimore Regional Housing Partnership, under the Fair Housing Act, can obtain information that is necessary to evaluate if a requested for reasonable accommodation is necessary because of a disability. Depending on individual circumstances, third party verification may be required.

    A doctor or other medical professional, a peer support group, a non-medical service agency, or a reliable third party who is in a position to know about the individual's disability may provide verification of a disability. Please place your third-party's contact information below.

  • Third-Party Contact Information
  • Consent for Information Release

    The purpose of your signature is to obtain verification of your disability that is relevant to the Baltimore Housing Mobility Program to determine if you are eligible for your requested accommodation. Your signature below authorizes the Baltimore Regional Housing Partnership to obtain verification from the reliable third party, such as a doctor or other medical professional, named on this form.

  • By signing below, I hearby authorize the release on the requested information

  • Date Format: MM slash DD slash YYYY

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