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2. If you require an accommodation under the Americans with Disabilities Act (ADA) for a Municipal Court program or service, it is recommended that you make your request at least 72 hours in advance in order to allow the Court time to review your request and make arrangements for the accommodation. All requests for accommodation, regardless of timeliness, will be given due consideration and if necessary, may require an interactive process between the requester and the Court to determine the best course of action. If your request is non-ADA related, please visit our website at CRgov.com/court for further information. If you need assistance in filling out this form, please contact the Court at Court@CRgov.com or by phone at 303-663-6123.
4. This form is confidential and not a public record.
6. Requestor is:*

   1. Party
   2. Observer
   3. Witness

   1. Attorney
   2. Juror
   3. Other (if other, explain)
7. Other:
9. Name*
11. Email address*
12. Phone number*
14. Mailing address
16. City
17. State
18. Zip
20. Service/Program Type
22. Case name and number
24. Dates and times when accommodations are needed.
26. Please describe the physical or mental limitation necessitating accommodation.
28. Please explain the type of accommodation(s) requested and any special requests or anticipated problems. Primary consideration will be given to the requested accommodation; however, the Castle Rock Municipal Court reserves the right to offer an alternative accommodation if one is more readily available and equally effective in accommodating your needs.
30. By completing this form, I attest that the above information is true to the best of my knowledge and I authorize this ADA request to be submitted.
32. Signature
33. Date
    Date
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field