CDOS ADA Grievance

Colorado Dept. of State ADA Grievance

This form is intended for members of the public. Current Department of State (Department) employees should not use this form and should, instead, refer to the Department's Employee Handbook for process guidance.
Get Help with This Form

If you have questions about this form, need an accommodation, or a different format, please contact the ADA Coordinator by email at accessibility@coloradosos.gov or by phone at 303-894-2200. The ADA Coordinator will respond to the complaint within 15 days and will require an additional 15 days to investigate.

Electronic Filing Terms

By completing this electronic grievance form, I affirm that I:
- Have read and understood the process outlined herein, including the normal timeline of events.
- Understand that my electronic signature, to be provided at the end of this form, shall be valid and used in lieu of a wet (ink) signature.
- Agree to be contacted via phone, postal mail, or email as necessary using the information I provide on this form.
Electronic Filing Terms*

I have read and agree to the Electronic Filing Agreement without exceptions
Name*

First NameLast Name
Email*
example@example.com
Preferred Phone Number*
Please enter a valid phone number.
What type of phone number is your preferred number?*

CellHomeWorkOther
Alternative Phone Number
Please enter a valid phone number.
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Information about your grievance*
Reason for grievance/complaint, or why you feel you have been discriminated against. Be specific and provide as much information as possible i.e. location, date, time, names etc.
Submit your grievance

Your completion of the fields below represents your electronic signature. Your electronic signature is valid and binding, just as pen-and-ink signature would be.

Select or enter today's date. The selection of a different date will not alter process timelines.
Signature*

First NameLast Name
Date*

MonthDayYear
Contact Information

Email: accessibility@coloradosos.gov

Phone: 303.894.2200
Should be Empty:

Colorado Dept. of State ADA Grievance