Tom Green County, TX · Tom Green County
ADA Accommodation Request Form
Tom Green County residents can use this form to request an accommodation for county services, programs, or activities.
At a glance
- Issued by
- City of Tom Green County · Tom Green County, Tom Green County, Texas
- Notarization
- Not required: file this form without a notary.
- Official source
- tomgreencountytx.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This form lets people request accommodations for services, programs, or activities made available by Tom Green County. It asks for contact details, the requested accommodation, and any specific information that could help the County evaluate the request. The form includes a disclosure statement explaining that some or all submitted information may be subject to disclosure under the Texas Public Information Act.
Who needs it
People requesting an accommodation for a service, program, or activity made available by Tom Green County should complete this form.
How to submit it
Submit the completed form to the Tom Green County ADA Coordinator/Risk Manager at 113 W Beauregard Ave., 2nd floor, San Angelo, TX 76903, by calling (325) 659-6507 or emailing [email protected].
About notarization
This document is signed without a notary; the signer just signs and dates it on the form.
How to submit this form
- 1
Download the Form
Download the ADA Accommodation Request Form.
- 2
Complete the Form
Provide the required contact information and describe the accommodation requested, including any helpful specific details.
- 3
Review and Sign
Read the disclosure statement, check the box confirming you understand it, and sign and date the form.
- 4
Submit to the County
Send the completed form to the Tom Green County ADA Coordinator/Risk Manager at the address or email listed on the form.
Frequently asked questions
- Do I need a notary for the ADA Accommodation Request Form?
- No. The form has a signature and date field but no notary block; the signer just signs and dates it.
- How do I submit the ADA Accommodation Request Form?
- Submit it to the Tom Green County ADA Coordinator/Risk Manager at 113 W Beauregard Ave., 2nd floor, San Angelo, TX 76903, or email [email protected].
- What information does the form ask for?
- It asks for your name, email, home phone, street address, city, state and ZIP, and details about the accommodation you are requesting. Work phone is also listed.
- What does the disclosure statement say?
- It says some or all information submitted using the form may be subject to disclosure under the Texas Public Information Act.