Assistance Animal Accommodation Request Animal 1 of 1 — please complete one form for each animal.Requesting Tenant/Applicant InformationComplex Name(Required)Unit Number(Required)Full Name(Required) First Last Phone Number(Required)Email Address(Required) Animal InformationSpecies(Required)Breed (if known)(Required)Animal's Name(Required)Age(Required)To your knowledge, has the animal ever bitten, attacked, or injured a person or another animal, caused significant property damage, or displayed behavior that created a serious health or safety concern?(Required) Yes No If yes, please describe what occurred, when it occurred, and what steps were taken afterward.Trained Task VerificationHUD’s May 22, 2026 FHEO enforcement memorandum directs HUD enforcement to focus on animals individually trained to perform specific work or tasks directly related to a person’s disability. This memorandum is enforcement guidance, not a change to the Fair Housing Act. Each request will be evaluated individually under applicable law.Please describe any disability-related work or tasks the animal has been individually trained to perform. HMR will review the request individually under applicable law and current HUD/FHEO guidance. If the animal has not been individually trained to perform specific disability-related tasks, please enter “No specific tasks.”(Required)Supporting DocumentationPlease attach reliable documentation, when reasonably necessary, from a licensed healthcare provider with personal knowledge of your disability-related need. The documentation should explain the disability-related need for the accommodation and how the animal assists you. HMR may request additional reliable information about claimed task training when relevant.Documentation from your licensed healthcare provider(Required)Accepted file types: pdf, jpg, jpeg, png, doc, docx, Max. file size: 10 MB. Veterinary Records — breed, age or approximate age, weight, and vaccination records(Required) Drop files here or Select files Accepted file types: pdf, jpg, jpeg, png, doc, docx, Max. file size: 10 MB, Max. files: 5. Picture of Animal for identification (Full-Size Colored Photo)(Required)Accepted file types: jpg, jpeg, png, heic, Max. file size: 10 MB. CertificationCertification(Required) I certify that the information provided is true and accurate. I understand that HMR evaluates each request individually under applicable federal and state law and current HUD/FHEO enforcement guidance. I acknowledge that I have read the HMR Assistance Animal Guidelines and Owner Responsibilities. Signature(Required)Signature Date(Required)
