File a Grievance

Complaints or grievances should be filed within 60 days of the incident and should contain information about the alleged discrimination.

The use of this grievance process as a means to achieve a prompt and equitable resolution shall not impair the complainant’s pursuit of other remedies, such as filing a complaint with responsible federal and state agencies and it not a prerequisite to pursuing other remedies with outside agencies.

* Starred fields are mandatory in order to process your request.

1 Complainant Information

*Name of Complainant:

*Address:

*City:

*State:

*Zip:

Phone:

*E-mail address:

*Confirm e-mail address:

2 Details of Grievance

*This grievance is regarding:

AGO Website
AGO Facility
AGO Sponsored Program
Service

Please provide a detailed description of the incident:

What could we have done to improve your experience?

3 Privacy Notice, disclaimer and signature

Some or all of the information submitted on this form may constitute a public record. By selecting I Agree below, I acknowledge that my request, once submitted, may become a public record subject to review by the Attorney General’s Office for applicable restrictions on disclosure.

I Agree

*Name:

*Declared this date:

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