Request for Reasonable Modification

Any person seeking a reasonable modification of SamTrans policies, practices or procedures, may complete the brief request form below. If a customer believes they have been discriminated against by SamTrans on the basis of a disability, they may submit a complaint via the SamTrans Contact form HERE.

Mode of Transit

Caltrain

SamTrans

Redi-Wheels/RediCoast

Other

Specify below

Other

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

E-mail

Daytime phone

Details

Describe in detail the modification you are seeking to accommodate your disability and why the modification is necessary for you to use the service(s) you indicated above.

Request for Reasonable Modification

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