Discrimination Complaint Form for Students with Disabilities for Parents, Student, School Staff and/or Third Parties
Our administration at the School District of Philadelphia Policy,  pursuant to 103.1 Non Discrimination-Qualified Students with Disabilities/Protected Handicapped Students policy, created grievance procedures that provides for the prompt resolution of complaints alleging any prohibited actions under the policy.

The policy outlines the district’s commitment to ensuring all individuals have equal access to education in this district regardless of race, color, age, creed, religion, sex, sexual orientation, ancestry, national origin or handicap/disability, gender identity, or genetic information. The policy also requires the district to provide academic and nonacademic services and programs equally to students with and without disabilities.

Any student, as well as parents, school team members and third parties, who believe that a student has been subject to conduct that violates this policy may submit information below so the District’s Section 504/Chapter 15 Specialist may review and support you in the best way possible.

This form should be used for any student who is eligible for a 504 plan or is thought to be eligible and you feel has been discriminated against. 

Thank you!


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