Form Ddd-1432a - Critical Service Gap Report Page 3

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DDD-1432AFORFF (6-17) - PAGE 3
FOR DIVISION USE ONLY
Date Received
Date of Response
Check Response Type
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Equal Opportunity Employer/Program • Under Titles VI and VII of the Civil Rights Act
of 1964 (Title VI & VII), and the Americans with Disabilities Act of 1990 (ADA), Section
504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and Title II of
the Genetic Information Nondiscrimination Act (GINA) of 2008; the Department prohibits
discrimination in admissions, programs, services, activities, or employment based on
race, color, religion, sex, national origin, age, disability, genetics and retaliation. To
request this document in alternative format or for further information about this policy,
contact the Division of Developmental Disabilities ADA Coordinator at 602-542-0419;
TTY/TDD Services: 7-1-1. • Free language assistance for DES services is available
upon request. Ayuda gratuita con traducciones relacionadas con los servicios del DES
esta disponible a solicitud del cliente.

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