Skip to main content

Reasonable Accommodation/modification Request Form

The Arizona Attorney General’s Office is committed to providing equal access to its programs, services, and activities. Individuals with disabilities may request reasonable accommodations to ensure meaningful access. Note: This form is intended for disability-related accommodation requests for programs, services, and activities provided by The Arizona Attorney General’s Office. It is not intended for requests for accommodations from private businesses, general complaints, or requests to change public processes.

All requests for accommodation will be acknowledged via email, along with a copy of your completed form. 

If you need assistance filling out this form, please contact the Arizona Attorney General’s ADA Coordinator:
Email: [email protected]
Phone: 602-542-8046

 

Requester Information

How would you like to be notified of the status of your request?

Request Details

Disability-Related Need

Are you requesting this accommodation due to a disability?

Accommodation Request

(Examples of accommodations may include: sign language interpreter, captioning, accessible documents, alternative formats, or assistance with physical access.)

Additional Information

Have you previously requested this accommodation from the Arizona Attorney General’s Office?
May we contact you if additional information is needed to process your request?

By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.