Americans with Disabilities Act (ADA)

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ADA Grievance Form

All fields with an asterisk (*) are required for submittal.

Part 1 – Report an Accessibility Barrier

The Caltrans Americans with Disabilities Act Grievance Process addresses access requests that pertain specifically to Caltrans infrastructure (physical structures) such as sidewalks, curb ramps, accessible pedestrian signals (APS), etc. for persons with disabilities or their representative experiencing issues accessing Caltrans infrastructure.

Caltrans jurisdiction includes State Route Highways and adjacent pedestrian pathways. If the location is outside Caltrans jurisdiction, your request will be forwarded to the responsible agency. You will also be notified with a letter including the contact information for the responsible agency.

For Non-ADA related requests (obstacles on the roadway, potholes, landscape issues, signage, graffiti, homeless encampments, or requests for new installations for crosswalks or pedestrian warning beacons, etc.), please submit a Customer Service Request (CSR) to Caltrans at: https://csr.dot.ca.gov/.

Description of ADA barrier

The description of the grievance should provide the general details of the access barrier including your concern and how it affects your daily activities.

* ADA Grievance or Barrier (such as sidewalks, curb ramps, accessible pedestrian signals):

Where is the location of grievance or area of barrier?

This information will allow us to pinpoint location. This allows us to coordinate with local government personnel as well as Caltrans district personnel.

* Address or Location:

* Highway Route:

* Direction of Travel (i.e. Northbound, Eastbound, etc.):

Nearest Cross Street:

In or Near City/Town:

Zip Code:

County:

Part 2 – Your Contact Information

* First Name:

* Last Name:

Preferred Contact Method:

* Email:

Phone:

* Address:

Apt/Suite:

* City:

* State:

* Zip Code:

Alternate Formats

This form is also available in alternate formats upon request by phone or in writing to: