Request for reasonable accommodation

Use this form to request reasonable accommodations for any person needing assistance in accordance with the Americans Disabilities Act, Washington State Policy 188, Section 508 of the Rehabilitation Act of 1973, and other relevant state and federal laws.

If you need assistance to complete a job application, please call Human Resources at 360-407-6186. Applicants wishing to use the Washington Relay Service may dial 711 or 1-800-833-6341.

To request accommodation

Please fill out and submit the following form to request reasonable accommodation for any of our services or activities.

For assistance with this form: email ecyadacoordinator@ecy.wa.gov or call 360-407-6831 (voice).
For TTY or Washington Relay Service, call 711 or 877-833-6341.

Request for written materials (printed or online)

Do you need accommodation for written or electronic materials? *

Yes No

Meetings or Events

Do you need accommodation for a meeting or event?

Yes No

Other requests

If your request for accommodation is not for written materials or a public meeting or event, please describe your request in detail.

Requestor information

Name *

Street address

City, State, ZIP code

U.S. phone number

Email *

Please re-enter your email address *