ADA Accommodation Request - Eleventh Judicial Circuit of Florida

Your request has been submitted. A court representative will contact you regarding your request.

Person Requesting Accommodation

Full Name

Full name is required.

Role in the Proceeding

Please select a role.

Street Address

City

State

ZIP Code

Email Address

A valid email address is required.

Phone Number

Name

Relationship to Requester

Phone

Case Number

Case Style

e.g., Smith v. Jones

Assigned Judge

Date Needed

Time

Location / Courtroom

Expected Duration

Case Type

Proceeding Type

Nature of the functional limitation requiring accommodation

Type of accommodation requested

Please select a type of accommodation.

Additional details or specific requirements