ADA Complaint Form
Title II of the Americans with Disabilities Act requires that Escambia County make county facilities, programs and services accessible to persons with disabilities in accordance with the standards of the ADA. If you feel that you have not been able to access a county facility, program or service because of a lack of accessibility or that you have been discriminated against because of your disability, please complete the form below or contact the Escambia County ADA Coordinator, Eric Kleinert, at 850-595-1637 or email@example.com
Please fill out this form completely and click the submit button at the bottom of the form.
Use [TAB] to maneuver forward through the fields. Use [SHIFT+TAB] to maneuver backward through the fields.