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504 Grievance Form



Section 504 Grievance Form

Must contain a date in M/D/YYYY format
Child's Namerequired
First Name
Last Name
Child's Date of Birthrequired
Complainant's Namerequired
Please describe your concerns and why you believe they raise an issue under section 504. Include a description of what happened, when and where it happened, and who was involved.
Explain the steps you have already taken to resolve the issue, if any.
Describe what resolution to your concerns you would like to see.
Please provide any other information you think will help with the investigation of your complaint.