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Accessibility Complaint / Grievance Form

Contact
Grievance
Review

Form Instructions

If you wish to file a grievance related to problems accessing particular pages or sections of the website, please complete this form.
All fields marked "required" must be completed.
This material can be made available upon request in an alternative format as required by the Americans with Disabilities Act of 1990.
In lieu of submitting this form online, you may choose to download and mail a printed version: Grievance Form PDF
To request in-person accommodations under the Americans with Disabilities Act, please visit the Request for Accommodation page.
For other accessibility concerns or to activate the AudioEye toolbar, please visit the Accessibility page.
For further assistance, you may direct your request to the ADA Title II and Section 504 Coordinator listed below.

Step 1: Contact Information

Name of Grievant (required) Please enter the name of the grievant

Person Preparing Grievance (if different from Grievant)

Relationship of Preparer to Grievant (if applicable)

Address of Grievant (required) Please enter the street address of the grievant

City (required) Please enter the city of the grievant's address

State (required) Please enter the State of the grievant's address

Zip (required) Please enter the zip code of the grievant's address

Phone Number of Grievant (required) Please enter the 10-digit phone number of the grievant

Further Assistance

For further assistance, you may direct your request to the following:

Attn: Tim Hagan
ADA Title II and Section 504 Coordinator
Pikes Peak Regional Building Department
2880 International Circle, Suite 100
Colorado Springs, CO 80910
Email: Accessibility@pprbd.org
Phone: 719-327-2880