Response

For matters in which emergency assistance is needed, please direct such requests to law enforcement or the appropriate agency head.

Information for Complaint Submitter

First Name

Last Name

Address Line 1

Address Line 2

City

State

Zip

Phone

Cell Phone

Parent/Guardian Name

Information regarding the Child

Child Name

Child's Age

Child's Birthdate

Nature of Complaint

County where the incident occurred

Agency involved

If you chose DSS, please choose which division of DSS is involved.

If you choose Other for Agency Involved, please choose an option for the dropdown.

Details regarding the incident