The Los Angeles County Public Works (Public Works) is committed to ensuring that no person shall be discriminated on the basis of disability in the admission and access to its services, programs, or activities. To report an issue regarding accessibility, please complete this form.

Person Completing Form (select one):

* An authorized representative is a person with authority to act in the best interest of the participant.

Customer Information:

Authorized Representative (if applicable):


Accessibility Complaint Information:

I believe the discrimination I experienced was based on (check all that apply):


Please describe how Public Works has not complied with delivering its programs and services. Provide sufficient details to support your complaint.