Complaint Tracker System

Enter Complainant's Information

If you are making a complaint; State Law at A.R.S 41-1010 requires that a name of the Complaint shall be public record unless the affected agency determines that the release of the Complainant's name may result in substantial harm to any person or to the Public Health safety.

* Are you submitting anonymously?

Yes

No

Notes/Comments

Please note Full name and contact information is still required to submit complaint. Although anonymous reports are accepted, we request your contact information so that we may contact you if we need additional information to properly address your complaint.

* Do you feel that the release of your name may result in substantial harm?

Yes No

* Notes/Comments

* First Name

* Last Name

Contact Information

Please enter a contact email - You will receive an email at this address to verify your complaint submission

* Email Address

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To create a new Yahoo email address, click here

* Primary Phone Number

Alternate Phone Number

May leave a message at the phone number provided

Address (Number & Street)

Address 2 (Number & Street)

City

State

Zip

* Complainant Source

Please provide me the final determination

* By submitting this form electronically, I state that I have read the complaint contents and the statements are true by my personal knowledge or I believe them to be true.