ARCHITECTURAL BARRIERS ACT ONLINE COMPLAINT FORM

PLEASE READ THE FOLLOWING PRIVACY INFORMATION BEFORE SUBMITTING A COMPLAINT ONLINE

Our regulations for handling Architectural Barriers Act complaints require that we keep the identity of a complainant confidential unless we receive written consent to release the information. However, since we cannot guarantee the privacy of information submitted over the Internet, your rights to confidentiality are waived when you submit your complaint to us using this online complaint form. Therefore, if you prefer that your identity remain confidential, please submit your complaint in writing by printing, filling in, and mailing us the alternate complaint form. Otherwise, you may submit your complaint by completing the following form.

ABOUT YOU. The following personal information is not required for us to investigate your complaint; however, it will allow us to send you periodic updates.

Name
Organization
Address
City
State Zip:
Phone () Ext. (daytime)
E-mail

ABOUT THE FACILITY. The following information is necessary for us to begin our investigation of your complaint. Although not required, the owner's name and telephone number will be helpful. Please provide as much detail as possible about the inaccessible areas of the facility.

Facility
Address
City
State Zip:
Owner
Phone () Ext.

Describe in detail the type and location of each barrier to accessibility.