ADA Complaint/Assistance Form
Please fill out as much of this form as you can. If you need help, tell us, and we would be happy to provide it. If you don't know the answer to something, please leave it blank.
The ADA Complaint/Assistance Form is available in electronic form, Microsoft Word and PDF format for your convenience. Completed forms can be entered on the form, returned by email, mail or fax to the Office of Disability Rights.
** Microsoft Word Format: Forms marked with two asterisks (**) are in Microsoft Word. Type your information directly into the fields (gray boxes) then save and print the form. To move from field to field, use the Tab key.