ADA Accommodation/Barrier Removal Request Form

Request for Accommodation or Barrier Removal 

Requests for Accommodation or Barrier Removal is established to meet the requirements of the Americans with Disabilities Act of 1990 and may be used to request an accommodation or request the removal of a barrier on the basis of disability in the provision of services, activities, or programs.

Request for Accommodation

A person who requires an accommodation on the basis of disability to participate in a City program, service, or activity, should submit a Request for Accommodation to the ADA/504 Coordinator.  The Request for Accommodation Form should be submitted as far in advance as possible, but no later than seventy-two (72) hours before the scheduled event.  

Request for Accommodation Form

Request for Barrier Removal

An individual may also submit a Request Barrier Removal on the basis of disability when seeking the removal of a physical barrier in order to gain or improve access to a City program, service, or activity. All Barrier Removal requests are reviewed and prioritized by the City of Lebanon with regard to the budget and scheduled projects.

Request for Barrier Removal Form

The City will review the request and, when pertaining to an event, will notify the requesting person of the City’s proposed resolution as soon as possible.  Responses pertaining to other requests will be provided within 15 days of receipt of the request.  The City’s response will be in writing or a reasonable alternative format if requested.  If an individual believes the City’s response is unsatisfactory, he or she may submit a formal complaint using the ADA Grievance Form. 

Please see the Grievance Procedure page for more information and to access the Grievance Form.

Other arrangements for submitting either Request Form, such as personal interviews or tape recordings, as well as assistance in completing the form, are available.To request an accommodation and/or an alternate format, please contact Kathleen Vail, ADA/504 Coordinator at 615.444.3647 ext 2320.

Communications Policy

The City of Lebanon ensures that no person or groups of persons shall, on the grounds of race, color, sex, religion, national origin,age, disability, or genetic information, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any and all programs, services, or activities administered, its recipients, sub- recipients, and contractors.