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2. 
3. Complaint/Grievance Form

   If you have a complaint that a program, service, or activity of the Town of Firestone is not accessible to a person with disabilities, you should complete the form below or contact Jody Miller at jamiller@firestoneco.gov or 303-531-6282.

   Please Note: this grievance procedure is for facilities, services, and programs owned and/or operated by the Town of Firestone. 

5. Your Name (complainant)
7. Address1
9. Address2
11. City
12. State
13. Zip
15. Phone Number
16. Email Address
18. Reason for grievance/compliant, or why you feel you have been discriminated against.

    Please be specific and provide as much information as possible, including location, date, time, names, etc. 

Leave This Blank:


20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

* indicates a required field