Online Complaint Form
Information about you
Information about the Incident
Please be as specific as possible.
Information about the employee
We understand that the full name of the employee may not be known. Please be as specific as possible. For example, report the person’s gender, race, approximate age, identifying features (e.g. mustache, long hair, wears glasses), approximate height, weight, etc.
Name and/or physical description of the employee: |
|
|
Detailed Description of the Incident
Please describe the incident in detail: |
|
|
Witness / Others Involved
Witness / Other 1
Witness / Other 2
Witness / Other Additional Information:
Desired outcome
Please describe what you would like to have happen as a result of this complaint:
Attestation of the Fact
By selecting the button below you affirm that all information in this complaint is true and correct to the best of your knowledge: