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Americans with Disabilities Act Title II Grievance Form

  1. Americans with Disabilities Act Title II Grievance Form

    Form for accessibility concerns.

  2. Individual discriminated against (if other than complainant).

  3. If you have documentation, copies would be helpful. Examples are letters, email messages, written notes, etc.

  4. Has a complaint been filed with State or Federal Agency?

  5. TENNESSEN WARNING

  6. The data you supply on this form will be used to process the ADA grievance you are submitting. You are not legally required to provide this data, but we will not be able to process the ADA grievance without it. The data will constitute a public record if and when the ADA grievance is submitted.

  7. By typing your name, this serves as electronic signature to the information stated above.

  8. Leave This Blank:

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