* = required information
What is your relationship to the child or family?*
Primary Language (Optional)
Do you need interpretation or translation services?
Is the parent currently represented by an attorney?*
With whom does the child reside?*
Who is the family's current DSHS caseworker?
If your complaint involves multiple subjects, you may address the additional subjects in conversations with your assigned Ombuds.
Please check this person's agency or profession
Other Professional or Service Provider
Provide a BRIEF SUMMARY of the agency action or inaction that you are complaining about and the date or dates of the incident(s). You can
provide more specific detail when an ombud contacts you.*
Example: My nephew was placed in foster care and my nephew's caseworker is refusing to place him with me
because my husband has a criminal record.
Please describe the reason you think the agency action or inaction was wrong or unreasonable.*
Example: Be brief, but provide as many facts as you can.
What action are you seeking to resolve your complaint?*
Be as specific as you can.
Example: I want the caseworker to reconsider letting my nephew live with me..
How did you hear about the Family and Childrens' Ombuds?
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