File an ADA Grievance | ��Ĵ�ý

The ��Ĵ�ý (��Ĵ�ý) is dedicated to providing equal access to all educational programs, services, and activities for individuals with disabilities.

If you encounter an accessibility barrier such as a physical, digital, or course-related obstacle, or have been denied reasonable accommodation, you may use this form to submit a formal complaint or grievance.

You can follow up on completed forms by emailing the ADA Compliance Officer at adacompliance@umgc.edu.

Please note: the ��Ĵ�ý ADA Compliance Office will confirm receipt within five business days from your submission.

In addition, a determination will typically be issued within 30 business days, unless additional time is needed.

File a Complaint or Grievance

Please fill out the form below to contact ��Ĵ�ý's ADA Compliance office. All fields are optional unless otherwise designated.

Contact Information

Full Name

* Required

Full Name is a required field.

Student ID (optional)

Student ID is a required field

Phone Number

Required

Please check your phone number (numbers are only allowed).

Phone Number is a required field.

��Ĵ�ý Email

* Required

Please check your email format (screenname@student.umgc.edu).

��Ĵ�ý student email is a required field.

Type of Accessibility Concern (check all that apply)

Denial of reasonable accommodation(s) Physical access barrier (e.g., classroom, building, parking, campus facility) Digital or online access barrier (e.g., learning management system, website, course content) Third-party platform, application, or vendor barrier Course design or instructional material barrier (e.g., inaccessible documents, videos, assessments) Other accessibility concern (please specify)

Please select one accessibility concern type.

Please Specify Your Other Concern

* Required

Description of Other Accessibility Concern is required.

Description of Accessibility Concern

Please provide a detailed statement addressing the following:

Description of the accessibility barrier or issue.
The date(s), location(s), and individuals involved (if applicable).
The impact of the barrier on your ability to access or participate in ��Ĵ�ý programs or services.

Description

* Required

The Description of the Accessibility Concern is required.

Informal Resolution Efforts

This type of concern does not need any informal resolution efforts noted. A ��Ĵ�ý ADA Representative will be in contact with you.

Describe any steps you have already taken to resolve this issue informally (e.g., discussions with faculty, staff, Disability Services, or IT) (optional).

Resolution Requested

This type of concern does not need you to note a specific requested resolution at this time. A ��Ĵ�ý ADA Representative will be in contact with you.

State the outcome or remedy you are seeking (if known) (optional).

Supporting Documentation

List and attach any documents, screenshots, course materials, or other evidence relevant to your grievance.

First Supporting Document (optional)

Accepted file formats are .doc, .docx, and .pdf. File size cannot exceed 10MB.

Second Supporting Document (optional)

Accepted file formats are .doc, .docx, and .pdf. File size cannot exceed 10MB.

Third Supporting Document (optional)

Accepted file formats are .doc, .docx, and .pdf. File size cannot exceed 10MB.

Fourth Supporting Document (optional)

Accepted file formats are .doc, .docx, and .pdf. File size cannot exceed 10MB.

Acknowledgment

I affirm that the information provided in this complaint is accurate to the best of my knowledge.

I affirm

Acknowledgment of this form is required.

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ADA Student Complaint & Grievance Form

File a Complaint or Grievance

Supporting Documentation

Acknowledgment

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