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Accommodation & Facility Access Request Form

  1. The City will make all reasonable modifications to policies and procedures to ensure that individuals with qualified disabilities have an equal opportunity to enjoy all City programs, services or activities. The City has the right, on a case-by-case basis, to determine whether a request is “reasonable” and whether or not the accommodation can be provided without jeopardizing the safe operation of the program, service or activity. The City shall not be required to make any modification that fundamentally alters the nature of the program, service or activity, or would result in undue administrative or financial burdens, as determined by the head of the department offering the program, service or activity. Requests for accommodation should be submitted as far in advance as possible, but not later than 48 hours prior to the need for the accommodation. Please use the form below to submit a request for a modification to policies or procedures in order to equally participate in City of Wichita Falls programs, services or activities or to request removal of architectural barriers in City facilities.

  2. 2. Contact Info

  3. 3. Preferred Contact Method*

  4. 4. Relationship to Applicant*

  5. 5. Type of Request (Select all that apply)*

  6. 11. Specify the reason(s) you are requesting an accommodation (select all that apply):

  7. Online Submission Notification All requests submitted online are sent directly to the City of Wichita Falls ADA Coordinator for action. The City will provide written acknowledgment of your request within 10 days. A written response to your request will be provided no later than 21 days from receipt of the request.

  8. Leave This Blank:

  9. This field is not part of the form submission.