Client Grievance Form

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You have the option of filing either an informal grievance or a formal grievance on Disability Rights Connecticut.

The informal option is an oral grievance offered as a way to quickly resolve an issue. If you choose this option, you must contact the appropriate supervisor within 30 days of the action you are grieving.

The formal grievance is a written grievance that generally takes more time for a response than the informal grievance. If you choose this option, you must file a written grievance within 30 days of the action you are grieving.

Full grievance policy: https://www.disrightsct.org/s/Grievance-Procedure-Form-jtbb.pdf

If you are unable to file a grievance in writing due to your disability, please contact DRCT’s Executive Director to request an accommodation.

Disability Rights Connecticut
846 Wethersfield Avenue, Hartford, CT 06114
(800) 842-7303 (toll-free in CT), (860) 297-4300 (voice), (860) 509-4992 (videophone)
Email: info@disrightsct.org Website: www.disrightsct.org

Formal Grievance

Please fill out your contact information so we may be able to follow up with you about the grievance.

Name (First, Last) *

Home Address

Phone Number

Email Address

Best way to Communicate with You (Phone, e-mail)

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