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To request an accommodation, submit the name, address and telephone number of the individual requesting the accommodation in writing. The request should include the location of the program, service, activity or facility where the accommodation is required and a description of why the accommodation is needed. Alternate means of filing a request will be made available as needed. The request should be submitted to the City of Clarksville ADA Coordinator at:

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Hatem Shah
ADA Title II Compliance Coordinator
1 Public Square
Clarksville, TN 37040
Phone (931) 648-6112
Phone (931) 645-7464
TTY 1-800-848-0298
Fax (931) 553-2471
hshah@cityofclarksville.com
7:00am - 3:30pm Monday through Friday

Within 15 calendar days of the written request, the ADA Coordinator will respond to the individual requesting the accommodation. If the response by the ADA department Coordinator does not satisfactorily resolve the issue, the individual making the request may file a formal grievance with the ADA Coordinator.

All written requests for accommodation will be kept by the ADA Coordinator for the City of Clarksville for a minimum of three years.

Request for Accommodation / Grievance Form
Last updated: 6/28/2012 11:34:21 AM