ADA Statement of Grievance Form

Please fill out the online form below. If you would like to fill out a physical form, download the form here and submit to Court Administration at the Duval County Courthouse, Room 7134, 501 West Adams Street, Jacksonville, Florida 32202.

( ) -
( ) -

Complete the following section if the complaint is being filed by a person other than the individual making the complaint.

( ) -
( ) -

Complaint Information

Witness Information

Witness 1

( ) -
( ) -

Witness 2

( ) -
( ) -