Accommodation Request Form

A. General Information

First Name(Required)

Last Name(Required)

Address(Required)

Street Address Address Line 2 City Province Postal Code

Email(Required)

File Information

Complaint/Notification Number, if known

Police Service/Law Enforcement Agency, if known

Date of Request

B. Request Details

I have a need related to the Human Rights Code, 1990 that may impact my ability to file a complaint or participate in the complaint process. The enumerated grounds under the Human Rights Code,1990, include race, ancestry, place of origin, colour, ethnic origin, citizenship, creed, sex, sexual orientation, gender identity, gender expression, age, marital status, family status, disability or the receipt of public assistance.(Required)

Yes

I have a need related to the Accessibility for Ontarians with Disabilities Act, 2005.(Required)

Yes

Please explain your need or concern and how it affects your ability to participate in the complaint process. Include all necessary information and be as specific as possible. If you do not provide enough information, the LECA may not be able to provide accommodation to meet your needs.(Required)

Please send any supporting documents, if necessary, to leca.accommodation@ontario.ca.

C. Next Steps

Send this completed form to the LECA as soon as you can to avoid any delay.

If the form is complete and the LECA has all the information it needs, the LECA will review your request and determine the availability of the appropriate alternate arrangements. The LECA may contact you if it needs more information.

How quickly the LECA makes a decision depends on the nature of your file and the information you provided. The LECA will attempt to provide you with a response as expeditiously as possible.

The LECA will work with you to put in place the accommodation that would help meet your need and remove the barrier in accessing the public complaints system.

Collection of Information

Information in this form is collected by the Law Enforcement Complaints Agency for the purpose of processing a request for accommodation under the Human Rights Code, R.S.O. 1990, c. H.19 and Accessibility for Ontarians with Disabilities Act, 2005, S.O. 2005, c. 11 to allow an individual to participate in the complaints process under the Community Safety and Policing Act, 2019, S.O. 2019, c. 1, Sched. 1.
The Information within this form may be accessed and used by the LECA and any agency or individual who has been directed by the Complaints Director to review, investigate, or deal with a complaint.

This field is for validation purposes and should be left unchanged.