This Grievance Procedure is not intended to resolve employment-related complaints of disability discrimination or harassment. • In writing: Fill out a complaint form or write a letter and send it to: Attn: Grievance and Appeals Department.Santa Clara Family Health Plan. Title VI complaints must be filed within 180 days from the date of the alleged discrimination. Non-Discrimination Statement. Grievance Form (Attachment 1). What happens after you fill out a reasonable accommodation request? • In writing: Fill out a complaint form or write a letter and send it to: Attn: Grievance and Appeals Department. Santa Clara Family Health Plan. Discrimination is against the law.