Subject: Communication Accessibility

This written notice is to inform you that due to a hearing loss I will need to have certain services, which may not be familiar to you and I ask that you provide them without charge to me as the law requires:

____A “qualified Sign Language Interpreter”. I request a Certified Interpreter from the National Registry of Interpreters for the Deaf, the National Association of the Deaf or Michigan's Division on Deaf and Hard of Hearing. This will assure that the person is appropriately skilled and impartial.

____An accessible hotel room. This means that I will need the following auxiliary aids: ___________________________

____Access to your facility for my service animal. Many people are more familiar with “seeing eye dogs” than service animals. My service animal provides similar help for me due to my hearing loss.

____Real Time Transcription by a Qualified Individual.

____The following:________________________________

Communication Accessibility is covered in both federal and state laws. If you would like further information, please call the toll free number of the Department of Justice at 1-800-514-0301 (voice) or 1-800-514-0383 (tty). You can also contact Michigan’s Division on Deaf and Hard of Hearing at 1-877-499-6232.
Copyright 1997
By: Brinks & Associates, Attorneys (Grand Rapids, Michigan)
Permission is hereby granted to reproduce this document without charge as long as this notice is reproduced on all copies.