Hawaii Assistance-Animal Housing Accommodation Request
HAWAII ASSISTANCE-ANIMAL HOUSING ACCOMMODATION REQUEST
Date: [__/__/____]
To housing provider or manager: [NAME AND ADDRESS]
From applicant or resident: [FULL NAME]
Dwelling: [STREET ADDRESS, UNIT, CITY, HAWAII ZIP]
Request
I request a reasonable accommodation under Haw. Rev. Stat. § 515-3(a)(9) to keep the assistance animal identified below in my housing accommodation. The animal helps address a disability-related need and supports my use and enjoyment of the home. Please review this request individually and respond in writing.
Animal name, species, and description: [________________________________]
Rule or practice affected: [NO-ANIMAL RULE OR OTHER RULE]
Accommodation requested: [PERMISSION TO KEEP THE ANIMAL OR SPECIFIC RULE CHANGE]
How the animal helps with a disability-related need, without a diagnosis: [________________________________]
Supporting information
☐ My disability and need for the animal are readily apparent. Please tell me if you believe additional information is needed to evaluate this request.
☐ My disability or need for the animal is not readily apparent. I enclose a letter or other communication from my treating health care professional, mental health professional, or social worker verifying the relevant disability-related information and animal-related need. Enclosure: [DOCUMENT DESCRIPTION].
☐ I can provide the verification permitted by § 515-3(a)(9) if you identify what information you need and a private way to send it.
Please identify any proposed restriction on this animal so that we can discuss whether it is reasonable. Section 515-3(a)(9) permits reasonable restrictions when an accommodation includes an assistance animal. I ask that any verification request follow that section's limits: no medical records or access to my health care providers, and no inquiry into my diagnosis or the nature or severity of my disability. I am not relying on an online animal registration, tag, or vest as verification.
Send your response to: [EMAIL OR MAILING ADDRESS]
Telephone (optional): [PHONE]
Requester signature: [________________________________] Date: [__/__/____]
Delivery record
I delivered this request to [NAME OR OFFICE] by ☐ email ☐ mail ☐ hand delivery ☐ housing portal on [__/__/____].
Delivery confirmation or tracking: [DETAILS]
Official reference
About this template
- Last updated
- October 28, 2026
- Citations checked
- October 28, 2026
- Jurisdiction
- Hawaii
- Category
- Landlord & Tenant
Legal authority
- Haw. Rev. Stat. § 515-3(a)(9), (b)
Landlord-tenant paperwork governs who can stay in a property, on what terms, and what happens when something goes wrong. Leases, notices to quit, security deposit demands, and habitability complaints all have state and often city-specific requirements for timing, content, and service. Getting the paperwork right is what makes an eviction actually succeed or a security deposit actually come back, because judges regularly dismiss cases over small procedural mistakes.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on October 28, 2026.
Haw. Rev. Stat. § 515-3(a)(9) (checked October 28, 2026): "To refuse to make reasonable accommodations in rules, policies, practices, or services, when the accommodations may be necessary to afford a person with a disability equal opportunity to use and enjoy a housing accommodation"
Haw. Rev. Stat. § 515-3(a)(9) (checked October 28, 2026): "An owner or other person engaging in a real estate transaction shall not request medical records or access to health care providers, and shall not inquire as to the diagnosis, nature, or severity of the person's disability"
Haw. Rev. Stat. § 515-3(b) (checked October 28, 2026): ""assistance animal" means an animal that is needed to perform disability-related work, services, or tasks for the benefit of a person with a disability or provide emotional support that alleviates one or more identified symptoms or effects of a person's disability"
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