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ADA Grievance Form

  1. Under Title II of the Americans with Disabilities Act (ADA), Maricopa County is required to ensure that our facilities, services, and programs are accessible to people with disabilities and in compliance with the ADA.

    If you feel that you have not been able to access the County government facilities, services, or programs because of accessibility issues, or have been discriminated against based on your disability, please provide the details requested below. Your complaint will be investigated and you will be contacted with the results or additional instructions on how to further proceed. This form and process are designed to provide you with the opportunity to quickly and effectively resolve any issue(s) as they relate to the ADA and Maricopa County.

    This grievance procedure is solely for facilities, programs, and services owned and/or operated by Maricopa County.

    If your grievance is related to a non-County owned business (Title III businesses), please contact the U.S. Department of Justice Information Line at 1-800-514-0301 for assistance.

  2. Section 1. Contact Information
  3. Section 2. Complainant Information
  4. Are you filing this complaint on your own behalf?
  5. If yes, skip to section 3.
  6. If No, please provide the following contact information for the person discriminated against:
  7. Section 3. Incident Description
  8. Section 4. Incident Information
  9. Have you discussed your complaint with a County employee?
  10. Have you filed your complaint with a federal, state, or local agency; or with a federal or state court?
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  12. By inputting my name below, I affirm that the above is true to the best of my knowledge, information, and belief.
  13. Leave This Blank:

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