Request to Add an All-Gender Restroom


First & Last Name(s)
Chosen name(s) welcome.
Chosen last name(s) welcome.
The name of the building where the restroom is located.
The floor level in the building where the restroom is located.
If available, the number associated with the primary door of the restroom. Often these numbers are located on the top of the door frame or on signage for the restroom.
Please provide a brief description of the location of the restroom.
Is the restroom available to the public during open building hours?