Report an ADA Grievance

Please complete the form in its entirety, as it constitutes your formal complaint against the City of Leavenworth. Fields marked with an asterisk (*) are required. Upon request, alternative means of filing complaints, such as personal interviews or a recording of the complaint, will be made available for person with disabilities. For questions or to request alternative means of filing a complaint, contact the ADA Coordinator at 913-680-2602 or email penny.holler@firstcity.org.

Complaintant's Full Name and Contact Information
Discriminatory Incident
Date Discrimination Occured
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