Brookfield - ADA Accommodation Request

Use this form to request reasonable accommodations; please complete it to the best of your ability.

Please provide at least 48 hours’ notice prior to the date that the accommodation is needed.
While every attempt will be made, it may not be possible with less than 48 hours' notice.

For assistance completing this form or requesting accommodations, please contact:
accommodations@brookfieldma.us OR +1-508-867-2930 Extension 10

Town of Brookfield's ADA Accommodation Policy

Request same accommodation as last time?
Date of Accommodations Date of Accommodations / MM / DD YYYY
Name
Phone | Email (provide both if either works)
Meeting | Program | Service
What accommodations are you requesting?
✦PLEASE DO NOT PROVIDE ANY SENSITIVE INFORMATION.
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