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Complaint Intake Form - UCDD
We want to hear from you. If your experience with UCDD has been less than satisfactory, let us know.
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Complainant's Name
*
Complainant's Phone Number
*
Complainant's Email
*
Complainant's Address
*
County where incident occurred
*
Cannon
Clay
Cumberland
DeKalb
Fentress
Jackson
Macon
Overton
Pickett
Putnam
Smith
Van Buren
Warren
White
Other
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Date of Complaint
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Complaint: Check All That Apply
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Services Provided
Services Not Provided
Employee Actions
Policy Decisions
Other
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Other Complaint Topic
Who/What is the Subject of Complaint
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Complaint Details
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Witness Name
Witness Address
Witness Phone Number
How would you like this resolved?
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