ADA Request & Complaint Form/Grievance Proc


This form is to be used only for requests or concerns about access, for those with disabilities, to City of Elk Grove buildings, programs, services or activities. Concerns pertaining to buildings and programs not operated by the City of Elk Grove should be directed to the appropriate responsible party. Complete the information below with or without the assistance of City staff. After completion of this form, click on "Submit" (Printable Form below)

Access Request and Complaint Form for Persons with Disabilities
ADA Access Request and Complaint Form for Persons with Disabilities

The City will make every effort to address your concern within a reasonable period of time. You will be contacted by the ADA Coordinator within five (5) business days. If your concern pertains to an agency other than the City of Elk Grove, we will forward this form to the responsible agency.

All written complaints and responses will be retained by the City of Elk  Grove for at least three years.

If the response by the ADA Coordinator or designee does not satisfactorily resolve the concern, the complainant may appeal the decision  within fifteen (15) business days after receipt of the response to the City Manager or designee.

Security Measure

Accessibility Resources

ADA Coordinator

Jim Ramsey
Email, (916) 478-2250, TTY/TDD (888) 435-6092, or fax (916) 627-4250

8401 Laguna Palms Way
Elk Grove, CA 95758

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