ADA Complaint Form

Municipal Facilities ADA Complaint Form
ADA Information

• Grievance Procedure under The Americans with Disabilities Act (ADA)
• Town of Smyrna ADA Complaint Form (Downloadable)

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Date of Complaint*?

Complainant*

Email Address*

Phone Number*

Address*

City*

State*

ZIP Code*

City Facility Name / Location*

Nature of Complaint*

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Digital Signature (Please click here for digital signature)

Signature Date*