Disability Complaint Form
Your complaint form has been submitted.
Disability Complaint Form
* Last Name
* First Name
M.I.
* Address
* City
* State
* Zip Code
* Email
* Phone Number
* This is being filled out by
-- Select one --
Self
Someone on behalf of the voter
HC Election Judge, Election Worker, or Staff
* Election
May 04, 2024 - Uniform and Special Elections
March 05, 2024 - March 5 Primary Elections
* Vote Center
-- Select one --
* Date of visit to the vote center
* What challenges or discrimination did you encounter voting at the above referenced vote center?
Issues with accessible parking
Issues with getting into the polling place or getting to the voting area (accessibility of polling location)
Issues with accessible voting station or machine
Issues with curbside voting
Issues with obtaining assistance by a person of the voter's choice
Inability to vote independently or privately
Issues with effective communication or auxiliary aids or services
Issues with election judge, election workers, Harris County employees, or other staff
Other
* Please describe these challenges or issues in more detail:
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Please list the names and contact information (phone number, e-mail address, etc.) of any witnesses. If applicable, please also include their relationship to you.
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Did you speak to any election judges, election workers, or employees at the Vote Center about the challenges you encountered? If so, please list their name(s) if you know it (them).
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What, if any, accommodations were made to address the challenges you encountered at the vote center?
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What, if any, accommodations would you suggest be made at this Vote Center?
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Do you have any other comments or suggestions related to your voting experience?
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