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2. Americans with Disabilities Act (ADA) Complaint Form

   If you need assistance in completing this form or have questions, please email Anja Croon, Risk Management Technician/ADA Coordinator or call 303-486-5744.  You can also request assistance in person at:

   City Hall
   6060 S Quebec Street
   Greenwood Village, CO 80111
   Monday through Friday
    8 a.m. to 5 p.m.
   (closed major holidays)

4. Name
5. Email Address
7. Address
9. City
10. State
11. Zip
13. Nature of Complaint

    Please describe the reason for your grievance/complaint, or why you feel you have been discriminated against.  Be as specific and provide as much information as possible including, but not limited to:

    • Date
    • Time
    • Location
    • Names of present
    • Any other relevant information
15. What do you think should be done
17. Please allow 30 calendar days following the ADA Coordinator's receipt of this complaint for us to investigate and respond to your complaint
Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field