Reasonable Modification Request Form

MM slash DD slash YYYY

I certify as follows:

If Redwood Coast Transit Bus Route(s), please select route(s).
I understand that Redwood Coast Transit is not required to modify its services to provide personal care attendants, service animal supervision, medical services, service outside its service area or hours of operation, modifications which would cause a direct threat to the safety of others, modifications which would cause a fundamental alteration of its service, modifications that would impose an undue administrative or financial burden on Redwood Coast Transit or Redwood Coast Paratransit, and modifications which would result in an illegal act.(Required)

Electronic Signature

Please type your First and Last Name
MM slash DD slash YYYY
I understand that checking this box constitutes a legal signature confirming that I acknowledge the truthfulness of the information provided.(Required)
Translate »