Issues & Concerns •

If you’re experiencing an issue with the department administration that is not being solved at the captain level, or you wish to document an incident with administration, please fill out the form below.

Remember, personnel issues are to be solved through the chain of command only. This form is for issues with administration in order to document and request assistance if necessary.

Name

Names are not required, however the e-board will need your name if you would like direct follow up.

First Name

Last Name

Personal Email

When did the concern start/incident occur?

If an exact date is not known, please provide closest estimation.

MM

DD

YYYY

Nature of concern/Incident

Please describe. If the date above is an estimation, please indicate so here.

Has this been brought to a Captain?

Yes

No

If appropriate, would you like union assistance?

Yes

No

Issues & Concerns •

Issues & Concerns • Issues & Concerns •

Issues & Concerns •