DORA Section 504 Grievance and Discrimination Complaint Form
It is the policy of the Department of Regulatory Agencies (DORA) not to discriminate on the basis of disability in its facilities, services, programs, or activities. DORA has adopted an internal grievance procedure providing for prompt and equitable resolution of complaints alleging any action prohibited by Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794) of the U.S. Department of Health and Human Services regulations implementing the Act.  Section 504 prohibits discrimination on the basis of disability in any program or activity receiving Federal financial assistance. DORA's Nondiscrimination Notice, Policy, and Section 504 Grievance Procedure may be found at https://dora.colorado.gov/.

Any person who believes they have been subjected to discrimination on the basis of disability may file a grievance under this procedure. It is against the law for the department to retaliate against anyone who files a grievance or cooperates in the investigation of a grievance.

If an individual believes discrimination has occurred on the basis of disability, a written grievance can be filed with DORA’s Section 504/ADA Coordinator within 60 days of the incident using this designated complaint form. If needed, the Section 504/ADA Coordinator is available to help file the grievance. Request for assistance in completing the grievance form may be sent to dora_citizenadvocate@state.co.us or 303-894-2052 | State Relay: 711.

 The following information is necessary to assist the department in processing a complaint.
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Qualified Individual Information
First Name of Complainant: *
Last Name of Complainant: *
Primary Phone Number (Please include area code): *
Secondary Phone Number (Please include area code):
Mailing Address: *
City, State: *
Zip Code: *
Email: *
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