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ADA Title II Grievance

  1. Complainant's Name
  2. Individual Discriminated Against (if other than complainant) Information
  3. Alleged Violation
  4. Documentation
    If you have any documentation (letters, emails, messages, written notes, etc.), please upload them.
  5. Other Filing of This Incident
  6. Has this complaint been filed with a State or Federal Agency?*
  7. Leave This Blank:

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