ADA Complaint Form
The Americans with Disabilities Act of 1990 (ADA) requires that individuals with disabilities receive the same level of service as non-disabled individuals. Section 504 prohibits discrimination on the basis of disability in any program or activity receiving Federal financial assistance. Please provide the following information necessary in order to process your complaint. Should you require any assistance in completing this form, please let us know. You may also mail this form to us: Corporate Compliance Officer VNA at HCS P.O. Box 564 Keene, NH 03431