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Accommodation Request Form 

You will be submitting this request form for accommodation pursuant to the Human Rights Code (the “Code”)

General Information

The Code states that every person has a right to equal treatment with respect to services and facilities without discrimination or harassment because of one or more of the following prohibited grounds:

  • race
  • ancestry
  • place of origin
  • colour
  • ethnic origin
  • citizenship
  • creed
  • sex
  • sexual orientation
  • gender identity
  • gender expression
  • age
  • marital status
  • family status
  • disability

The Code includes an obligation on every service provider or owner of a facility to meet the special needs of individuals and groups protected by the Code unless meeting such needs would create undue hardship considering the cost, sources of funding, and health and safety requirements.  Some of the considerations related to each of these matters are as follows:


  • The determination of cost as an undue hardship is based on the circumstances of the Municipality as a whole and the nature of the accommodation requested.  Such costs must be quantifiable and may include capital, operating costs and the cost of re-structuring.

Outside Sources of Funding:

  • The availability of outside sources of funding may alleviate accommodation costs. These resources could be funds that may be available to the individual only or directly to the Municipality and may be provided through government programs (i.e. programs to improve accessibility for persons with disabilities).

Health and Safety:

  • There may be some situations where a health or safety requirement, legislated or not, effectively excludes someone from accessing municipal services. However, it must be determined whether any health and safety requirement can be modified or if alternatives can be found to protect health and safety.
  • If health and safety legislation allows a requirement to be modified, an equivalent safety measure may be used.  If the accommodation contravenes health and safety legislation and places you or others at significant risk, then undue hardship exists.

The accommodation of special needs is assessed and delivered on an individual basis for persons who make their needs known. Each request must be considered individually in order to assess any appropriate accommodation.  The Municipality has an obligation to explore all accommodation options and to implement an accommodation that is reasonable. Every accommodation request will be fully considered, and may be refused if no Code-related need is substantiated or if undue hardship can be demonstrated.

Please note that there may be no requirement for accommodation if:

  • the request is not linked to a prohibited ground in the Code
  • there is no supporting documentation provided or the supporting documentation is insufficient or not verifiable
  • the functional limitations do not trigger the need for accommodation when reviewed against the service being provided or the facility being accessed
  • evidence contradicts the information provided by the requestor

Request for Accommodation

Preferred method of communication (check one only)

I require an accommodation to access the service or facility for the following reasons (Include information about any functional limitations that are impacting your ability to access a service or facility.):

I have included the following documentation to support my request for accommodation (Include objective documentation to confirm the need for accommodation and the type of accommodation required.  Supporting documentation must be verifiable.  For example, a letter from a treating physical identifying functional limitations.)


Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Follow up and Response to Request

If additional information is required to assess your accommodation request you may be contacted via telephone.  You will receive a response to your request via the preferred method of communication that you indicated above.

Personal information is collected under the authority of the Municipal Act, 2001 and the Ontario Human Rights Code and will be used to determine accommodation pursuant to the Ontario Human Rights Code. Questions about the collection of this information should be made to the Director of Legal and Legislative Services, Municipality of Leamington, 111 Erie Street North, Leamington, Ontario. Phone: 519-326-5761.

Statement - Online Form Submission:

By submitting this online form to the Municipality, the user acknowledges that the submission is deemed to be a substitute for the user’s signature on the online form and signifies that the user has read, understood and agreed to the terms and conditions of the online form and any document referenced in the online form.

Please confirm that you have read and accept the "Statement - Online Form Submission"


© 2024 The Municipality of Leamington 111 Erie Street North, Leamington, Ontario N8H 2Z9

Phone: 519-326-5761
Fax: 519-326-2481
Email: General Information

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