To request assistance from the Office of Citizen Relations, use the secure form below.  Before you fill out the form, we strongly encourage you to read the information provided on this web site regarding what the Office of Citizen Relations can investigate.

The "Send" form button will transmit your form in a secure and confidential web connection.  You will be contacted within five working days by telephone, fax, or mail.

Please Note:  

  • Items with star "*" next to them are required fields.
  • For the larger text boxes, please make sure to separate lines/paragraphs by pressing the enter key for every 15 lines of text you enter.

 First Name:

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Last Name:

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Address Information:

 Address:

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City:

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 State:

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Zip Code:

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Telephone (Contact) Numbers:
        (if there is no contact phone, please put "none" in the number box and a dash in the area code box)
Contact Phone #:  Area Code:  (* required fields)
            Home  Work  Cell  Pager

Alternate Phone #:   Area Code:
            Work  Home  Cell  Pager  N/A

Fax #:   Area Code: 


The Office of Citizen Relations is open from Mondays to Fridays, 8:30am - 4:30pm, When is the best time to contact you?: 


Please Enter Any Contact Restrictions:
            


How did you hear about our office?

            


1. Which authority (ministry, municipality, school, college, or hospital, etc.) is your question or complaint about?     
      (Please identify by specific name)  
    (* required field, please separate lines/paragraphs by pressing the enter key for every 15 lines of text)

            

2. Who have you dealt with at  the authority?  
    (list any names, titles, phone numbers or addresses that you have.  If none then please state "None.")
    (* required field, please separate lines/paragraphs by pressing the enter key for every 15 lines of text)

            

3. Summarize your request for information or your complaint.  List any steps you have taken to try to resolve it: (* required field, please separate lines/paragraphs by pressing the enter key for every 15 lines of text)
     (please indicate any file or reference numbers and relevant dates).

            

4. Did you file an appeal or apply for a review?  If yes, when was the last appeal or review and what was the result? (please separate lines/paragraphs by pressing the enter key for every 15 lines of text)

            

5. Why do you believe the actions taken against you were unfair? (please separate lines/paragraphs by pressing the enter key for every 15 lines of text)

            

6. Describe the result or outcome that you seek. (please separate lines/paragraphs by pressing the enter key for every 15 lines of text)

            

7. If you consider the matter urgent, explain why. (please separate lines/paragraphs by pressing the enter key for every 15 lines of text)

            

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