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Municipal Complaint Form

COMPLAINANT CONTACT DETAILS

In order to sucessfully complete the investigation please ensure that valid contact information is provided.

First Name:

Last name:

E-mail Address (most prompt way we can communicate with you):

Mailing Address: (Please expect longer response times if only a mailing address if provided)

Phone Number:

COMPLAINT TYPE

Please choose 1 or more complaint types:

Access to Services

Facilities

Outcome of Existing Complaint

Processes and Procedures

Programs

Staff Conduct

Timeliness of Services

Other

SUMMARY OF COMPLAINT

Please include information on what happened, who was involved, date(s) and time(s). Be as detailed as possible.

Details of Complaint:

Service area / location of problem:

Staff persons involved (if known):

Please upload relevant documents here:

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RESOLUTION

How do you suggest the complaint be resolved?

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