Woman completing a Regional Municipality of Durham online form on a computer.

Form Builder

Required fields are marked with asterisks (*)

Request Accessible Format or Communication Support

The Regional Municipality of Durham is committed to providing information in the format that meets your needs. If you need information in an accessible format or with the assistance of a communication support, please complete this form and when you select the submit button your request will be sent to the Accessibility Coordinator. Alternatively, your request can be given by:

Calling 905-668-4113 extension 2009
Emailing the Accessibility Coordinator (accessibility@durham.ca)

All areas in the form marked as (Required)* must be completed.

First Name (Required)

Last Name (Required)

Address (Required)

City/Town (Required)

Province (Required)

Postal Code (Required)

Telephone (Required)

Email (Required)

Explain what information you need in an accessible format. For example, a document. Please provide details. (Required)

What type of accessible format would you like to receive the information in. (Required)

Information contained on this form is collected under the authority of the Municipal Act, R.S.O. 2001, c.25, and will be used to provide accessible support/services with the Region of Durham. Personal information contained on this form is collected in accordance with the provisions of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) and will be used to answer your request. Questions about the collection of personal information should be directed to the Corporate Privacy Officer at foi@durham.ca or (905) 668-7711 ext. 2204.