Americans with Disabilities Act | Maricopa County Superior Courts

Complainant Information

First Name: *

Last Name: *

Street Address: *

Address 2:

City: *

State: *

Zip Code: *

Phone Number: *

Email Address:

Alternate Contact Person - An alternate contact is NOT required

First Name:

Last Name:

Street Address:

Address 2:

City:

State:

Zip Code:

Phone Number:

Email Address:

Please Complete the Following

Nature of Disability: *

Date of Alleged Discrimination: *

Time of Alleged Discrimination: *

Please describe the particular way in which you believe you have been denied the benefit, service, program, or activity of the Superior Court, or have otherwise been subject to discrimination as a person with a disability by the Superior Court: *

Please state, if known, the names or positions of any Superior Court employees involved in the incident, as well as names, addresses and telephone numbers of any witnesses to any such incident, if necessary:

Security Code *

Questions?

Contact the ADA Office

Norma A. Quiroz

ADA Coordinator

Email: norma.quiroz@jbazmc.maricopa.gov

Address: 125 W Washington St. 4th Floor, Phoenix, AZ 85003

Phone: (602) 506-0094

ADA Grievance Form

Questions?

Norma A. Quiroz

ADA Coordinator