If you are an individual with a disability and require an accommodation to access OCR services, language interpreter services, or if you would like to be provided with this Complaint Form in another language please contact our Customer Response Center: 1-800-368-1019 (voice) or TDD: 800-537-7697 ; you may also send an email message to OCRMail@hhs.gov or fax to (202) 619-3818.