Mesa, AZ · Maricopa County
ADA Request for Accommodation
Applicants use this form to request an accommodation for a Mesa Municipal Court proceeding, service, activity, or program.
What this form is
Use this one-page request to ask Mesa Municipal Court for an accommodation under Title II of the Americans with Disabilities Act. It identifies the applicant, court program or proceeding, dates needed, impairment, requested accommodation, and any special requests or anticipated problems. The ADA Office may request information from an appropriate medical or psychological provider to understand the disability’s impact and help provide an appropriate accommodation.
Who needs it
A person seeking an accommodation for participation in a Mesa Municipal Court proceeding, service, activity, or program should complete this request.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This request is signed and dated without a notary; the ADA Office may request documentation from an appropriate medical or psychological provider.
How to submit this form
- 1
Download The Form
Download the ADA Request for Accommodation PDF.
- 2
Complete The Request
Provide your contact details, court program or proceeding, dates needed, impairment, requested accommodation, and any special requests.
- 3
Gather Supporting Information
The ADA Office may request documentation from an appropriate medical or psychological provider.
- 4
Submit To The City
Submit the completed request to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What is the ADA Request for Accommodation?
- It is a Mesa Municipal Court form for requesting an accommodation for a court proceeding, service, activity, or program.
- Who should complete this request?
- Applicants seeking an accommodation for participation in a Mesa Municipal Court proceeding, service, activity, or program can complete the form.
- Do I need a notary for the ADA Request for Accommodation?
- No. The form asks for a signature and date, not notarization. The ADA Office may request documentation from an appropriate medical or psychological provider.
- How do I submit the ADA Request for Accommodation?
- The form does not give a submission method. Submit it to the city department named on the form and check the city website for current contact details.
Need something notarized?
This ADA Request for Accommodation doesn’t need a notary — but if you have another Mesa form that does, a commissioned online notary can help.