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Request for Reasonable Accommodation or Modification

  1. The City of Pensacola is committed to compliance with the Americans with Disabilities Act (ADA) in all aspects of providing equal access to all city-sponsored programs and events and does not discriminate on the basis of disability in the city’s services, programs or activities. This form may be used by citizens to request a reasonable modification to the accessibility of a city program, service or facility. Please submit the form no later than 72 hours before the event for which an accessibility modification is needed in order for us to honor your request.
  2. Required fields are marked with an asterick *
  3. I am requesting the following accommodation or modification. * *
    Please click on one or more listed options.
  4. (Please provide a week advance notice for requests of printed materials in Braille.)
  5. All records, forms and communications submitted to the City of Pensacola pertaining to official business will be subject to disclosure under the Florida Public Records Law, unless they are defined by the law as exempt or confidential.
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  7. This field is not part of the form submission.