Corte Madera, CA · Marin County
ADA Grievance and Accessibility Complaint Form
This form lets individuals report an ADA-related grievance or accessibility complaint to the Town of Corte Madera.
What this form is
Use this form to report a grievance or accessibility complaint related to sidewalks, curb ramps, traffic controls, parks, Town services or activities, parking, or another concern. It asks for the complainant’s contact information, the complaint’s nature and location, and any recommendations. A proxy or representative can provide their information in Section III; the form includes instructions for completing it.
Who needs it
Individuals or representatives who want to report an accessibility complaint or ADA-related grievance involving a Town facility, service, activity, or other listed concern can use this form.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details. The form lists the Corte Madera Building Official as a contact for assistance.
About notarization
This document is signed and dated without a notary; it identifies no attachment or related step that must be notarized or sworn, so the signer just signs and dates it.
How to submit this form
- 1
Download the Form
Download the ADA Grievance and Accessibility Complaint Form.
- 2
Complete the Form
Enter complainant information, describe the grievance, identify its location, and provide any recommendations. Indicate in Section III if you are a proxy.
- 3
Review the Instructions
Refer to the attached instructions. The form says to write legibly in pen or type your responses.
- 4
Submit to the Town
The form does not give submission instructions. Check the city website for current contact details.
Frequently asked questions
- What can I report with this form?
- The form lists sidewalks, curb ramps, traffic control and devices, parks and recreational facilities, Town services and activities, parking, and other concerns.
- Can someone submit the form on another person's behalf?
- Yes. The form says a proxy or someone completing it for another individual should indicate this in Section III.
- Do I need a notary for the ADA Grievance and Accessibility Complaint Form?
- No. This form is signed and dated without a notary, and it identifies no attachment or related step that must be notarized or sworn.
- How do I submit the ADA grievance form?
- The form does not specify how to submit it. Check the city website for current contact details; the form lists the Corte Madera Building Official for assistance.
Need something notarized?
This ADA Grievance and Accessibility Complaint Form doesn’t need a notary — but if you have another Corte Madera form that does, a commissioned online notary can help.