Type of Accommodation

If "Other" is chosen, please specify

Party Requesting Assistance

(Contact information for the person filling out this form)

First Name
Last Name

Person Needing Assistance

(Contact information for the party needing services)

First NameFirst Name (assistance)
Last NameLast Name (assistance)
Phone NumberPhone Number (assistance)

How is the person needing assistance related to the case?

If "Other" is chosen, please specify

Date & Time Assistance is Needed

Dateof appointment
Estimated Length of Event

Mode of Hearing

Zoom Meeting ID & Passcode (if you have one)

Case Information

(Please type "Jury” in the field below if your request is for Jury Duty)

Case Number
If "Other" is chosen, please specify

Location of Appearance

Courtroom Number

Presiding Judge

Name of Judge (if known)your full name