Handicap Permit Request Please use the following form to request a Handicap Permit. Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *PhoneIf sharing your cell phone and by submitting this form, you agree to receive SMS from Eastside Senior Services. Carrier and Data rates may apply. Message frequency may vary Reply STOP at any time to end messaging or Reply Help for more information or you can say any information entered on this page will not be used to initiate SMSComment or Message *NameSubmit