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City of Kawartha Lakes
Human Services
Box 2600, 68 Lindsay Street North
Lindsay, ON  K9V 4S7

Request and Verification for Accessible Accommodation

Declaration and Consent: This section is to be completed and signed by the applicant, or if the applicant is less than 16 years of age, a parent or legal guardian.

I, the applicant, consent to my doctor verifying and disclosing the personal health information requested in this form for the purposes stated below. I declare the information given on this form is true and correct to the best of my knowledge. I have not knowlingly left out information or provided false information.

Personal information contained on this form is collected pursuant to the Housing Services Act, 2011, and will be used for the purpose of responding to your request.  Questions about the collection of this information should be directed to the City Clerk or Deputy-Clerk at 705-324-9411 extension 1295 or 1322.


Please complete the following questions in regards to your needs for accessible accomodation. Applicants and tenants are eligible for a modified unit based on a medical condition or disability. Most apartment buildings provide barrier-free features.

Do you have a medical condition or disability?
Are these impairments permanent?
Are your impairments caused by your medical condition or disability expected to get worse over time?

What types of special needs do you or another member of the household have?

Inability to climb stairs because of a disability or medical condition?
Requires a unit in a building with an elevator because of a disability or medical condition?
Requires a unit with accessible modifications to support a person with moderate or severe physical disability
Requires a unit with accessible modifications to support a person using a wheelchair
Accessible Parking

What features are you or another member of the household applying for:

Wheelchair accessible (wider) doors or doorways
Lower kitchen cabinets and lower countertops
Automatic building entry doors
Accessible bathroom (roll under sink etc.)
Roll-in shower
Accessible Kitchen (roll under sink etc.)
Fire alarms for those who have a hearing impairment (strobe smoke detectors)
Unit features for those who have a vision impairment

Many of the accessible units have varying accessibility modifications. City of Kawartha Lakes - Housing Services staff work with applicants to assist them in applying for appropriate housing choices. Once the applicant receives an offer of housing for a modified unit, they should work with the Housing Provider to ensure that the specific unit meets their accessibility requirements.

For tenants currently in an accessible unit, regular verification of need is required to ensure legislative compliance.

Changes to your condition or need for accessible accommodation must be provided to our office within 30 days.

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