Home Making a Complaint How to Complain Fairness / Treatment / Actions of Public Body Administration (Ombudsman Act) Complaint Form

Fairness / Treatment / Actions of Public Body Administration (Ombudsman Act) Complaint Form

Ombudsman Act Complaint Form

Last Name(Required)

First Name(Required)

Address(Required)

Street Address City Postal Code

Daytime Phone Number(Required)

Other Number

Email Address(Required)

May a message be left at your daytime telephone number?

Yes

Are you representing someone else in this complaint?

Yes

Last Name

First Name

Address

Street Address City Postal Code

Daytime Phone Number

Other Number

Email Address

What is your complaint?(Required)

Who is your complaint about and when did it happen? (Specify the provincial department, agency or municipality the complaint is about.)(Required)

Whom have you dealt with about this problem? (List names, phone numbers, addresses and when you last had contact with them.) Explain the steps you have taken to solve this problem.(Required)

Have you received anything in writing from the department, agency or municipality? (Please tell us what you have received. We may ask you to fax or mail these documents to our office after we review your complaint.)(Required)

Did you file an appeal or ask for a review? If yes, when was the last appeal or review and what was the result?

Why do you believe you have been treated unfairly?

How can this problem be solved?

Is this matter urgent? Please explain why.

CAPTCHA