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If the request is being made by someone else on behalf of the rider, please provide name, relationship to the rider and telephone number below

This form can be requested in large print or Spanish by calling (602) 253-5000; TTY (602) 251-2039; or emailing

Electronic versions of the completed form and scans of required documentation of disability should be sent to

Valley Metro will provide a written response to your Request for a Reasonable Modification within seven (7) days of its receipt. To check on the status of the request, call Valley Metro Customer Service at (602) 253-5000; TTY: (602) 251-2039.