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GENERAL COMPLAINT


Please fill out the following information...then click "SUBMIT".

Your Name:

  (Name)
  (Address)
  (City, ST ZIP) ,
  (Daytime Phone)
  (Other Phone)
  (email)
 

Complaint Against:

  (Name)
  (Address)
  (City, ST ZIP) ,
  (Phone)
  Complaint Detail:
 
By clicking the submit button below I agree to the following statement:
I acknowledge and agree that this complaint will become part of our permanent records.
This form is also subject to Oregon's Public Records Law and may be disclosed to persons who request to review its contents.
As such, it may be released to the business or person about whom you are complaining, members of the public, or other agencies if requested.

If you want to be informed of the results of your complaint you must acknowledge that you understand and accept this by clicking the appropriate box.
If you wish to remain anonymous, you must still click the box but do not enter your contact information. You will not be notified of any results if you wish to remain anonymous.

 

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