Supreme Judicial Court and Appeals Court
Request for Reasonable Accommodation
John A
dams Courthouse
One Pemberton Square
Boston, MA 02108
INSTRUCTIONS:
To enable a person with a disability to access the Supreme Judicial Court or Appeals Court, information is
needed regarding the nature and extent of any requested accommodation. It is the policy of the courts to
process reasonable accommodation requests within 72 hours of the date the request is received.
I wish to make a Request for a Reasonable Accommodation:
Date of Request
Name:
Phone:
E-mail:
Address:
(Street) (City) (State) (Zip)
Status
Juror
Attorney/Legal Staff
Witness
Party
Other
Status (Specify)
Court Appearance:
Name of Court
Date of Appearance
Case Name and Docket#
Type of Accommodation Requested
Access:
physical access to parking lots/entrances/rest rooms/elevators/court rooms.
Issue-Related:
I need the following reasonable accommodations:
Sign Language Interpreter
Assistive Listening Devices
Large Print Digital Audio Reading
CART
(Computer Access Real-time Translation)
Other (please specify)
Date and Time Needed
at
AM
PM
Limitations Requiring Accommodation:
Signature of Requestor or Person completing the form
Relationship to Requestor
For Supreme Judicial Court submit to: Timothy Maguire, ADA Coordinator, John Adams Courthouse, Boston, MA 02108: (tel) 617-557-1140; (fax)
617-557-1052; timothy.maguire@jud.state.ma.us
For the Appeals Court submit to: Monique Duarte, ADA Coordinator, John Adams Courthouse, Boston, MA 02108: (tel) 617-723-1502; (fax) 617-626-7906;
monique.duarte@jud.state.ma.us Revised 4.23.19
