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ADA Complaint / Grievance 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 provide a complete description of the specific complaint or grievance.
Please specify any location(s) related to the complaint or grievance (if applicable).
Please state what you think should be done to resolve the complaint or grievance.
Do you wish to be contacted regarding this situation?
Please do not contact me personally
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