Public Complaints

The district is committed to providing excellent service and addressing public concerns in a fair, transparent, and timely manner. To do so, we ask that you fill out the Public Complaint Form in its entirety and provide any supporting documentation.

Paper Submission: You may complete the paper form and return it in person or by mail using the PDF file provided below. Return completed form to the district office at 2543 Shasta Way, Klamath Falls OR 97601.

Public Complaint Form.pdf

Online Submission:

Public Complaint Form

Todays Date: (required)

Please describe what happened in detail. Include as much information and documentation as possible: (Attach additional pages if needed) (required)

List any steps taken to date to resolve this complaint.

I certify that the information provided on or with this form is true and correct to the best of my knowledge. I understand that if this complaint is against an employee or board member, the individual being complained against may be notified of the complaint and my identity.

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

Read our Electronic Record and Signature Disclosure

I agree to use electronic records and signatures

Date:

Name:

Title: (Mt., Ms., etc.)

Mailing Address:

City:

State:

Phone:

Email:

What is the best way for you to be contacted:

Phone

Mail

CONFIDENTIALITY

I am requesting my name, home address, personal telephone number and email address remain confidential pursuant to ORS 192.355(4).

* If you request confidentiality, the district will not disclose your personal identifying information to members of the public to the extent permitted under Oregon Public Law (ORS Chapter192). PLEASE NOTE: If the complaint is against an employee of the district or a district board member. Release of your identity to the individual being complained against and the employing agency/business will most likely be necessary for investigative purposes.

IMPORTANT INFORMATION:

You will receive verification of receipt of your complaint by return mail. The complaint will be reviewed by the appropriate department and the Executive Director will be notified. Additional information may be requested if necessary. A formal response will be provided within 21 business days of receiving all necessary information. If additional time is required, the complainant will be informed of the expected timeline. All complaints will be handled with discretion, and information will only be shared with relevant personnel involved in the resolution process.

All information provided on this form is subject to Oregon’s Public Records Law (ORS 192.410 to 192.505). Klamath 911 may be required to release the information provided on this form, including your identity, if requested.

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