Please complete this form if you have a question, concern or comment regarding the service provided by Arrowhead Transit. Date (required) First Name (required) Last Name (required) Address Line 1 (required) Address Line 2 (required) City State Zip Phone Number (required) Preferred Email (required) Preferred Contact Method (required)---By PhoneBy Email Best Time to Contact You (required) Please describe in as much detail as possible the situation surrounding your complaint (required) What county did the incident occur in? Discrimination Complaint "Please complete this form if you feel that you have experienced discrimination by the Arrowhead Transit on the basis of race, color, national origin, sex, age, income status, or disability, in violation of the Title VI Act of 1964 and related statutes. The complaint must be filed no later than 180 calendar days of the alleged discriminatory incident. I believe I was discriminated against based on my (check all that apply)RaceColorNational OriginSexAgeDisabilityIncome StatusOther If "other", please explain Please describe in as much detail as possible the situation surrounding your discrimination complaint Request A Reasonable Accommodation Outline the accomodation Are you able to utilize the service without this accommodation?YesNo Request A Reasonable Accommodation File a Discrimination Complaint Δ General-complaint-submission-formDownload Discrimination-complaint-submission-formDownload Reasonable-accomodation-submission-formDownload