San Joaquin — Client Complaint Form

San Joaquin — Client Complaint Form (PDF)¶

CLIENT COMPLAINT FORM

Please complete the following items to help us better understand your complaint:

Name:

Address:

Daytime Telephone Number:

Case Number:

Do you have an attorney? Yes No

Name of Attorney:

This complaint is about: an individual(s) in the Family Court Services’ mediation or investigation office. a Family Court Services’ procedure.

both an individual and procedure.

the Court Order.

If an individual(s) is/are the source of your concern, please provide the name(s) below, if known:

When did the action about which you are concerned happen?

within the last month. within the last three months. within last year.

more than a year ago.

What is your complaint? Please be specific.

Revised 12/19 Page 1 of 2

What would you like to have done as a result of this complaint:

Is your mediation or investigation in progress at this time? Yes No

Last court date:

Next court appearance:

What other information do you think is important for us to know?

SIGN

Date Signature
(An unsigned or anonymous complaint will not be accepted.)

Revised 12/19 Page 2 of 2