ADA Policies, Procedures, And Forms

In accordance with the requirements of the Americans with Disabilities Act of 1990 ("ADA"), the City of Florence ("City") will not discriminate against qualified individuals with disabilities on the basis of disability in the City's services, programs, or activities. You can find PDF copies of our ADA Notice and Grievance Procedures below. 

If you have questions or need additional guidance or support please contact the City of Florence’s ADA Coordinator. 

Cortlyne Huppe, ADA Coordinator
City of Florence
600 West 3rd Street
Florence, CO 81226
(719) 784-4848, option 5

These forms and processes are designed to provide you with the opportunity to quickly and effectively resolve any issue(s) as they relate to the City of Florence and the ADA.

Your request or complaint will be investigated, and you will be contacted with the results or how to further proceed.

We will make reasonable modifications and accommodations to ensure that people with disabilities have equal opportunity to participate in all meetings and events. If you are a person with a disability who requires an accommodation to participate fully in a meeting or event, please request an accommodation in the form below. Or call us at (719) 784-4848, option 5, at least 48 hours prior to the start of the meeting or event. Please note the City’s operating hours to ensure efficient and accurate notification.

City of Florence Grievance Form Title II of the Americans with Disabilities Act 

This material can be made available upon request in an alternative format as required by the Americans with Disabilities Act of 1990. For further assistance, you may direct your request to the ADA Coordinator.

Name of Grievant (required)

Person preparing Complaint

Relationship of Preparer to Grievant

Address of Grievant (required)

City (required)

State (required)

Zip (required)

Phone Number (required)

Email Address (required)

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Nature of Grievance

Please provide a complete description of the specific complaint or grievance, including any incident, barrier, or perceived denial of benefit of any service, program, or activity: (required)

Please specify any location(s) related to the complaint or grievance (if applicable): (required)

Please state what you think should be done to resolve the complaint or grievance: (required)

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

Read our Electronic Record and Signature Disclosure

I agree to use electronic records and signatures

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City of Florence Request for Accommodations Form Title II of the Americans with Disabilities Act 

This material can be made available upon request in an alternative format as required by the Americans with Disabilities Act of 1990. For further assistance, you may direct your request to the ADA Coordinator.

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Name of Person Filling Out Form

Name (required)

Address (required)

City (required)

Zip (required)

Phone Number (required)

Email Address (required)

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

Read our Electronic Record and Signature Disclosure

I agree to use electronic records and signatures

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Individual Needing Accommodation

Name (required)

Address (required)

City (required)

Zip (required)

Phone Number (required)

Email Address (required)

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

Read our Electronic Record and Signature Disclosure

I agree to use electronic records and signatures

Please list the facility, program, service, event, or location for which you are requesting accommodation or barrier removal: (additional comments and/or relevant documents may be attached) (required)

Date(s) the Accommodation is Needed: (required)

What is the specific accommodation you are requesting? (required)

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