Americans with Disabilities (ADA) Act Request Form

ADA Accommodation Request

Please use this form to request accommodations under the Americans with Disabilities Act (ADA). We are happy to help ensure our programs and services are accessible to you.

How to Request Accommodations

Deadline: Please submit your request at least 7 business days before the event.
Online: Complete and submit the digital form below.
By Mail: Click here for a printable copy. Please sign and mail it to:

Executive Director
Lawrence Public Library
707 Vermont St., Lawrence, KS 66044

Need Help?

If you need assistance filling out this form, please reach out to us:

In-Person: Visit us at the library and inquire at any service desk.
Phone: 785-843-3833
Email: ada@lawrence.lib.ks.us

Note: Certification by a healthcare provider may be required. Under the ADA, the library is not required to take actions that would fundamentally change the nature of its services or create an undue financial or administrative burden.

Request for Accommodations

"*" indicates required fields

Name*

First Last

Phone

Address*

Street Address Address Line 2 City State

ZIP Code

Title of Event or Service*

Date of program or service*

Please include Day, Month, and Year.

Requested Accommodations*

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):

This form is protected by reCAPTCHA

If you require an alternate submission method, please contact us.

Comments

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

This information will be submitted via email. .