Service Dog Access Self-Advocacy Template

 Name and Title Company 

Name and Position Title

Address Line 1 

Address Line 2  

City, State, Zip

Date 

Salutation:  

Paragraph 1:  Briefly describe the problem. 

 Paragraph 2:  Describe the access issue.   Include date, time, location, names/ titles of all involved, use their words as much as possible.  

Paragraph 3:  Describe the steps taken by you so far to resolve the issue.  

Paragraph 4.  Summarize what you want.  Include specific action items.  Define your desired method and timing of the  response.  

Closing,   Signature  

C :  Send a copy to