Language Access Comments, Complaints, Compliments Form - English

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City of Austin Language Access Services Comments, Complaints, and Compliments Form

Office of Civil Rights | City of Austin
505 Barton Springs Road, 5th Floor, Austin, TX 78704
(512) 974-3251
E-mail

Your Feedback Matters: Your comments on this Language Access Services Form are appreciated and will help us improve the City of Austin’s language access services for limited English proficient (LEP) persons.

Form Instructions:

Choose whether you want to: 1) Report a Complaint; 2) Give Feedback (Comment, Compliment or Suggestion); or 3) BOTH
Fill out the corresponding section (Part 1 for complaints; Part 2 for comments, compliments or suggestions, or both Part 1 and Part 2 for both)

(Mail-in: If you prefer to mail in your feedback, you can download this PDF form and mail it to us.)

I would like to (choose one):*

Report a COMPLAINT Give Feedback (COMPLIMENT, COMMENT or SUGGESTION) Both

General Information

Today's Date*

Name (If you are filling out this form for another person, please provide YOUR contact information.)

First Name

Last Name

Phone

Address

Address Line 1

City

State

ZIP Code

My preferred language is (select one from the drop down)*

Best Contact Method

Email Mail Phone

Part 2. Give us Feedback (Comments, Suggestions and/or Compliments)

Please write comments, compliments or suggestions here: