Americans with Disabilities (ADA) Act Request Form

Please use this form to request accommodations under the Americans with Disabilities Act (ADA).

Please request event accommodations at least 7 business days in advance.

If you would like assistance filling out this form, please inquire in person at the library, call us at 785-843-3833, or email us at ada@lawrence.lib.ks.us, and we would be happy to provide assistance.

Please note that the ADA does not require the library to take any action that would fundamentally alter the nature of its programs or services, or impose an undue financial or administrative burden.

Certification by a health care provider may be required.

If you would like to fill out a paper copy of this form, please use this link to print off a copy. Thank you.

Request for Accommodations

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Name*

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Phone

Address*

Street Address Address Line 2 City State

ZIP Code

Requested Accomodations*

Please tell us about the accommodation you are requesting and how it will assist you in your use of library programs or services (e.g. ASL interpretation for a library program):

Name

This field is for validation purposes and should be left unchanged.

This information will be submitted via email. .

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Americans with Disabilities (ADA) Act Request Form

Request for Accommodations

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