ADA grievance form

The county has developed a grievance procedure to ensure that accessibility concerns are resolved quickly and fairly, as outlined in the Americans with Disabilities Act (ADA).

Fill out the form and click "submit." If you have issues with the form, or to file an oral grievance, call 612-348-7741.

Note that fields with an asterisk (*) are required.

Complainant - person filing grievance

Name

Date

Address

City

State

Zip code

Primary phone number (xxx-xxx-xxxx)

Email address

Person claiming accessibility issue (if different than above)

Name

Address

City

State

Zip code

Primary phone number (xxx-xxx-xxxx)

Email address

Description of issue (e.g. crosswalk, website, building concerns) and remedy sought

1000 character limit

If same complaint has been filed with another agency

Agency or court

Complainant name

Address

City

State

Zip code

Primary phone number (xxx-xxx-xxxx)

Date filed