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Americans with Disabilities Act (ADA) Grievance Form

  1. Note:

    Please let us know if any of our crosswalks, sidewalks, and/or intersections are not compliant according to the Americans with Disabilities Act. Fields marked with asterisk * are required.

  2. Information for the person filling out this form.

  3. Information for the Person discriminated against.

  4. Person Discriminated Against*

    Please select the person(s) to reference for this complaint/grievance.

  5. If someone else involved, please add their information.

  6. Complaint/Grievance Information

  7. If you wish to send any pictures or related documents, please upload them using the browse button to add files.

  8. Would you like a response from us?*

  9. Leave This Blank:

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