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To file an ada claim, go to www.ada.gov and click on the box “ opens in a new window file an ada complaint.” this will bring you to a page which outlines the ways and steps to file a. If you have experienced discrimination because of your disability, you can file a complaint with the government. Department of justice civil rights division 950 pennsylvania avenue, nw washington, dc 20530 3. Sign and return to the address on page 3.
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Please remember to save and/or print your completed appeal form before using the submit button. Name* (first, middle initial, and last) home phone* business phone email address state agency accused of denying disability access agency* department (if applicable) agency address phone number email incident details date of incident* State of michigan ada complaint form. Online file a complaint by submitting a report on the department of justice's civil rights division website.
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To file a complaint using by mail, send your complaint form to the following address: You will receive a confirmation number and your report is immediately sent to our staff for review. Web the ada dental claim form provides a common format for reporting dental services to a patient's dental benefit plan. Web report using our online form.
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By completing the online form, you can provide the details we need to understand what happened. City, state and zip code: Web address person denied disability access skip this section if you are filing this complaint for yourself. When you use the submit button the information is transmitted electronically to the state of michigan department or agency selected, and at the same time the information is.