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Association for Disabled Americans Inc.
6538 Collins Avenue #196
Miami Beach, FL 33141
Phone(305)864-7070
Fax(305)864-4140
Email forada@gmail.com
 

Complaint Form

Please fill out the form below to place a Complaint. Each field must be filled out in order for the form to be sent.

  1. Date:
  2. Please provide the following contact information:
    Name
    Title
    Organization
    Street address
    Address (cont.)
    City
    State/Province
    Zip/Postal code
    Country
    Work Phone
    Home Phone
    FAX
    E-mail
    URL
    DISABILITY
     

    Please provide the following information about the location:

    Location of facility
    with a Barrier?
    ACCESS Problem
    How did you
    hear about us?


Last revised: February 21, 2007