Disability Accommodation Request

You may request an accommodation for a City of Benicia program, service, activity, on behalf of yourself or a person with a disability. Please complete the fields to the best of your ability, there is no requirement to fill in all the fields to submit the form.  Please submit your request at least five working days before a scheduled event.  We will do our best to accommodate requests with fewer than five working days' notice.

Address *





Please describe the accommodation you are requesting. Provide as much detail as possible, including the date and location of the program, service or activity.

If you have questions, please contact the ADA Coordinator at:

Suzanne Thorsen, Assistant City Manager/ADA Coordinator
Phone: 707-746-4200
To use the California Relay Services (CRS), dial 711
adacoordinator@ci.benicia.ca.us



* - denotes required field