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Americans with Disabilities Act Discrimination Complaint Form

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Please complete this form if you find that the City of Winfield, Kansas, has not provided adequate accommodation for a disability. Fields marked with an asterisk (*) are required. If you wish to send attachments you may do so after submitting this form. You will receive a response email after you have submitted this form that will contain a complaint reference number and instructions on how you may send attachments.

Person filling out this form

Person(s) Discriminated Against (if other than the complainant)

Discriminatory incident

Click on "Submit" or "Submit & Print" to email your complaint directly to the City's ADA Coordinator. An investigation, as may be appropriate, will follow the receipt of a complaint. Your complaint will be addressed in writing within 30 business days.
* indicates required fields.