EOANF-MOD

Name

First Last

Phone

Is it ok for us to send texts to this phone number?

Yes, texting this phone is fine

No, please don't send texts to this number

We're not going to spam you. Texts can help us start the conversation and arrange a good time to talk.

An email allows us to send you information and questions quickly

Which topic(s) does your disability rights question involve?

Public Accommodations (organizations doing business with the public, including stores, museums, childcare, contractors, and healthcare)

Education

Employment

Government programs

Housing

Transportation

Digital accessibility

Physical accessibility of facilities

Service animals or emotional support animals

What are the key facts of your situation that are important for us to know? (for physical accessibility issues, please provide the address)

For example: I have a disability and requested my employer buy specialized equipment to help me do my job. They denied my request, saying it was not "required to perform the essential functions of your job"

List your question(s) or the goal you are looking for help with(Required)

For example: Is my employer allowed to deny my reasonable accommodation request? What can I do now?

City/town for the situation you are contacting us about(Required)

Do you need a translator?

No, English is fine

Yes

What language?

Good times for us to call you

What time periods between 9am and 5pm over the next week will you be available to answer our call? This is especially useful if we need to schedule a translator.

How did you learn about MOD?

For example: referred by AGO, google search for "reasonable accommodation"