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ADA Grievance form

  1. ADA Grievance Form

    Title II of the Americans with Disabilities Act, Section 504 of the Rehabilitation Act of 1973

  2. Please complete this section only if the aggrieved person is not the individual completing this form.

  3. Please describe the situation or way in which the program/facility is inaccessible, providing name(s) where possible of the individuals involved in the situation.

  4. Have efforts been made to resolve this complaint through a Request for Accommodation with the ADA coordinator?*

  5. Leave This Blank:

  6. This field is not part of the form submission.