Special Education Dispute Resolution

Due Process Complaint Form

Online Due Process Complaint Web Form

Due Process is the most formal of the dispute resolution options and may be used to resolve any matter relating to the identification, evaluation, placement of a child, or the provision of a Free Appropriate Public Education (FAPE) to the child. A due process complaint can be filed by a parent, the school, or a student who has reached the age of majority (18 in Arizona).
The party filing a due process complaint notice may either use the form found on the Arizona Department of Education website at http://www.azed.gov/disputeresolution/due-process-hearing/ or may submit the complaint in the form of a letter. In either format, a due process complaint must contain specific criteria in order to meet the sufficiency requirements set forth in the federal law.
The party filing a due process complaint must provide the complaint to the other party.

Please complete the following:

Requestor

Parent/Guardian

Charter/District

Attorney

Other If other,

First Name

Last Name

Phone Number

Email Address

Parent/Guardian Information

Parent/Guardian

Selected?	First Name	Last Name	Phone Number	Email Address
Is Selected?	First Name	Last Name	Phone Number	Email Address

Student(s)

Selected?	First Name	Last Name	Date of Birth	Grade
Is Selected?	First Name	Last Name	Date of Birth	Grade

Address

Street Address

Address Line 2

City

State

Zip Code

Email Address

Charter/District Information

Charter/District

Please select a District or Charter School from the list below.

School Name

School Representative

Superintendent/Director

SPED Director

Other

First Name
Last Name

Address

Street Address

Address Line 2

City

State

Zip Code

Phone Number

Fax Number

Email Address

Attorney Information

First Name
Last Name

Address

Street Address

Address Line 2

City

State

Zip Code

Phone Number

Fax Number

Email Address

Issues

Federal law requires that you describe with specificity the nature of the problem(s)/complaint(s) and provide a proposed resolution to each identified problem(s)/complaint(s). Simply describing a problem as "student denied A Free Appropriate Public Education (FAPE) for school year 2023-2024" is insufficient. In the spaces below please identify specific problems(s)/complaint(s) and a proposed resolution for each to the extent known. Include facts, dates, references to specific IEP provisions, etc. Lack of specificity in identifying problem(s)/complaints(s) may result in the dismissal of this Due Process Hearing Request.

Please list issue(s)

Proposed Solutions

Please list proposed solution(s)

Attachments (Word/PDF Only)

Add Attachment(s)

Signature of Person Signing the Complaint

Please hover your mouse over the field and sign you name using the virtual pen.

Signature*

Note: Click on the symbol above to erase the signature.

Questions concerning this form, or the due process may be addressed by contacting:

Arizona Department of Education
Attn: Director of Dispute Resolution
1535 West Jefferson, Bin # 62
Phoenix, Arizona 85007
Phone: (602) 542-3084 Fax: (602) 364-0641
Email: ESSDRInbox@azed.gov

If you do NOT submit from this website, please send a copy of the complaint to the above email address, fax number, or mailing address.

Additionally: If you have submitted your complaint outside of regular business hours it will be considered received by Dispute Resolution on the next business day.