ADA Complaint Form

Redwood Coast Transit is committed to ensuring that no person is denied access to its services, programs, or activities on the basis of their disabilities, as provided by title II of the Americans with Disabilities Act of 1990 (“ADA”). ADA complaints must be filed within 180 days from the date of the alleged incident. Note: The following information is necessary to assist us in processing your complaint. Should you require any assistance in completing this form, please let us know.

Person discriminated against (if someone other than the complainant)
Person preparing complaint (if different from complainant)
MM slash DD slash YYYY
What time did the alleged incident take place?
Please include the date, time, route number, and exact location of any incidents.
If yes, check all that apply:
Please provide information about a contact person at the agency/court where the complaint was filed (if available).

Electronic Signature

Please type your First and Last Name
MM slash DD slash YYYY
I understand that checking this box constitutes a legal signature confirming that I acknowledge the truthfulness of the information provided.(Required)
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