SADCR Form 602-1 / 1824 Generator

§1 Select Form Type

SADCR — 602-1 Grievance Staff misconduct, complaints, or disability-based discrimination. SADCR — 1824 Reasonable Accommodation Access, participation in programs, or accommodation requests.

§2 Inmate Information

Last Name, First Name

SADCR Number

Institution or Parole Region

Housing and Bed Number

§3 Grievance — SADCR 602-1

Describe your complaint. Include the names of all involved; attempts to informally resolve the issue; and related log numbers from your central file.

Date of Event (if known)

Time of Event (if known)

Location of Event (if known)

Describe Your Complaint

§3 Reasonable Accommodation — SADCR 1824

Complete this section if requesting accommodation to access a program, service, or activity — or to report removal / denial of accommodation due to disability-based discrimination.

1. What can't you do / What is the problem?

2. Why can't you do it?

3. What do you need?

§4 Signature & Date

Your Signature (Character Name)

Date Signed

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