When a person’s disabilities prevent them from using or enjoying their housing in the same way as people without disabilities, they can ask for reasonable changes in their housing. This letter template can be used if your housing provider or landlord asks you to have your doctor or another service provider verify that you need the change. It can be from someone who knows about you and your disability, or from someone who knows about the change that you need. Or you can use this letter as a model to write your own letter. You should keep a copy of the letters that you send. Learn more on this page of our website.

Use this text or the PDF, below.

Verification of Disability for Reasonable Accommodation

Re: (Write your name)

Birthdate: (Write your birthdate)             

(Write your address)

(Write your telephone number)

 

To Whom It May Concern:

(Write your name) has a disability defined as a mental or physical impairment that substantially limits one or more major life activities. Major life activities include, but are not limited to, caring for oneself, performing manual tasks, walking, seeing, hearing, speaking,  breathing, learning and working.

(Write your name) ’s physical or mental impairment(s) substantially limit them in the following major life activities:

(List those that apply to you)

• caring for oneself
• performing manual tasks
• lifting objects heavier than
• walking
• running
• seeing
• hearing
• speaking
• breathing
• learning
• relating to others
• sleeping
• thinking
• reading
• writing
• understanding
• planning
• managing stress
• working
• other:

In my opinion, allowing (write your name) to (describe the accommodation you need) will help them with their disability and allow them an equal chance to use and enjoy their housing as others who don’t have disabilities have.

Sincerely,

(Signed by doctor, nurse, therapist or other professional)

(Write name of doctor, nurse, therapist or other professional)

Our PDF file, below, does not fully comply with all applicable guidelines for accessible digital documents. For the most accessible experience, use the text above.