[Date]

Dear [Insert School Principal Name], 
 
I am requesting a mask accommodation for my child, [Child’s Name]. My child [Explain the disability reason your child needs a mask accommodation]. 

I am including documents that explain why my child needs a mask accommodation to this letter. [Include any documents like a doctor’s note that support your request for a mask accommodation for your child].

I am requesting you to provide my child with a mask accommodation. The specific mask accommodation I am requesting is:

•	Different type of face covering/face shield
•	Changes to the classroom
o	Increased space between students
o	Plexiglass barriers
o	Seating my child near ventilation or air purification equipment
o	Other ___________________
•	Use of additional PPE for classroom staff
•	Staffing changes, such as ___________________
•	Instruction and/or services provided outside, in the home, or in another setting
•	Mask breaks for my child
•	Develop an IEP goal and plan to increase mask use
•	Other ___________________

School districts must provide a reasonable accommodation to students with disabilities who have a medical condition, mental health condition or disability that limit or prevents them from wearing a face covering/mask. Federal laws, including Title II of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act, require schools to provide reasonable accommodations so that students, like my child, can access services available to others. If the school denies my request for a reasonable accommodation for my child, the school will be in violation of these laws. Guidance from the Centers for Disease Control and Prevention and the California Department of Public Health provide exemptions to face covering/mask requirements for students with disabilities, like my child.

Schools must also follow the Individuals with Disabilities Education Act. This federal law requires schools to provide children with disabilities, like my child, with a free appropriate public education. If the school denies my request for a mask accommodation for my child for in-person instruction, the school will deny my child a free appropriate public education.

Please let me know as soon as possible whether the school will grant my child the mask accommodation requested above. 

Sincerely,

Parent/Guardian/Educational Rights Holder Name: ___________________

Address: ____________________________________________________

Telephone Number: ___________________________________________

Email Address: _______________________________________________