SAMPLE VERIFICATION LETTER FROM CARE PROVIDER OR RELIABLE THIRD PARTY:
[Date]
Re: Reasonable Accommodation/Modification for [Tenant’s Name and Address]
To Whom It May Concern:
I am writing as a [care provider or reliable third party] in a position to know about [tenant
name]’s disability. [Tenant name] is an individual with a disability as defined by the
Fair Housing Act. Due to [his/her/their] disability, [he/she/they] require(s) the following
accommodation or modification: (Examples: Permission to have an emotional assistance
animal in their unit, despite a no pet policy, or a reserved, accessible parking space near the
entrance to their unit.)
This patient’s disability affects their ability to (identify major life activity, which is affected
by the disability): __________________________________________________________. The request presented above is necessary in connection with their disability. Your prompt review and
written approval of this request is appreciated.
Signed,
[Name, Title, & Contact Information]

For more detailed information on requesting a reasonable accommodation or modification in housing,
please visit the web pages linked below:
Requesting RAs: https://www.hud.gov/sites/dfiles/FHEO/documents/huddojstatement.pdf
Requesting RMs: https://www.hud.gov/sites/dfiles/FHEO/documents/reasonable_modifications_mar08.pdf

QUESTIONS? CONTACT US.
Envelope: | advocates@thehousingcenter.org
Phone: | (216) 361-9240
www.thehousingcenter.org