Request for Accommodation by Person with a Disability

If you require an accommodation under the Americans with Disabilities Act (ADA) for a program or service, it is recommended that you make your request at least two weeks 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 www.coloradojudicial.gov for further instructions. If you need assistance in filling out this form, please contact the Jury Commissioner or ADA Coordinator. When you are done completing this form, please hit the "submit" button below and it will be forwarded to the appropriate judicial district. You will be notified by email once a decision is made on your request. Additional information may be needed to process your ADA request.

Genetic Information Nondiscrimination Act or 2008 Compliance:
When filling out this form, do not provide any genetic information which is defined to mean: information about the individual's family medical history, the results of an individual's or family member's genetic tests, the fact that an individual or individual's family member sought or received genetic services, and genetic information of a fetus carried by an individual or an individual's family member or an embryo lawfully held by an individual or family member receiving assistive.

NOTE: If you DO NOT HAVE AN EMAIL ADDRESS you can download a manual copy of the ADA request form.

Please provide the following information:

Request for Accommodation by Person with a Disability

Solicitante

Telefono

Número de jurado

Street Address

First Name

Last Name

City

State

Correo Electrónico

ZIP Code

County of filing

Tipo de servicio/programa

Court type

Nombre y número del caso

Tipo de Procedimiento

Fechas, horarios y ubicación cuando se necesitan adaptaciones

Please describe the physical or mental limitation necessitating accommodation

Explique el tipo de acomodación solicitada y cualquier solicitud especial o problema anticipado. Se dará consideración primero al alojamiento solicitado; sin embargo, el Departamento Judicial de Colorado se reserva el derecho de ofrecer un alojamiento alternativo si uno está más fácilmente disponible e igualmente efectivo para satisfacer sus necesidades.

I attest that the above information is true to the best of my knowledge and authorize this ADA request to be submitted.

YES, I agree.

CAPTCHA

Esta pregunta es para comprobar si usted es un visitante humano y prevenir envíos de spam automatizado.

9/13/24 Update re: Notice of Closure of Conejos County Courthouse

10/15/24 Be Aware of Jury Duty and Court Summons/Warrant Phone Scam

Request for Accommodation by Person with a Disability

Request for Accommodation by Person with a Disability