The complaint must be in writing and contain information about the alleged discrimination such as name, address, phone number of complainant and location, date,. The Division of Human Rights complaint form is available at the below link.You may use this form to file and submit your complaint online. The declaration option does not require notarization; you need only fill in the blanks with the date and your location (city, state), and sign the declaration. Mail Fill out and send the paper ADA Complaint Form. For a disability discrimination claim to be valid, you must first show that you actually qualify as disabled under the definition of "disability" in the ADA. (c) The ADA Compliance Officer shall provide persons seeking accommodation with the. Should you file a workplace discrimination claim? We can help you every step of the way. Free Consultation - Call (617) 521-8600.