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ADA Complaint / Grievance Appeal Form
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ADA Grievance Form
Title II of the Americans with Disabilities Act, Section 504 of the Rehabilitation Act of 1973
Designee Preparing Complaint (if different from Complainant)
Designee's Relationship to Complainant
Please check one.
Please provide a detailed explanation of why you believe the response from the response from the ADA Coordinator did not satisfactorily resolve your complaint.
Please attach a complete copy of your initial complaint and the response resolution letter from the City's ADA Coordinator.
If you have any additional pages, those can be uploaded here.
Additional file upload.
Appeal remedy requested.
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