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ADA Complaint Form

Please note!

Any person who believes that they have been discriminated against by the city of Phoenix, or one of the city’s service providers, and believes that the discrimination is based solely upon their disability, may file a complaint with the city. Any such complaint must be in writing and filed within 180 days following the date of the alleged discriminatory occurrence.

To file a complaint online, please complete and then submit this form. It is pre-addressed to arrive at the correct destination when you click on the “Submit” button below.

If you have questions or comments about the process, or want to email the Title VI Coordinator directly, please use this email address: PHXTransitEO@phoenix.gov.

In order for us to respond to your message appropriately, please fill in as much of the following information as possible.


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Incident Information *

Customer Information





Advocate Information





Incident Information

(Please enter in format: HH:MM AM/PM)
(Month, Date, Year; i.e. Jan. 1, 2019)
Major Crossroads: *

Crossroad One:

Crossroad Two:



Operator Name and/or Description:

Vehicle Number and/or Description:




Complaint Details




Additional Complaint Information


 
 

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Electronic Signature *

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