Housing Services
Grievance Submission Form

Please fill out this form as completely as possible. All grievances will be reviewed even if you do not have all the information now.

NOTE: if you do not leave contact information, we will not be able to follow up with you which will limit or prevent us from working toward a resolution on your behalf. Your information is confidential and we have a zero-tolerance policy for retaliation – you are safe to leave your name, phone, and email when submitting a grievance. While we can’t guarantee an outcome, all grievances are reviewed carefully and thoroughly.

Your Name

Your Phone Number

Home or Mailing Address

We review ALL submissions, and you may submit anonymously. If you would like to hear a response from us, please leave your name and phone or email above.

What housing, shelther, outreach, or homeless services do you receive from or in Washington County? Please select at least one.

(If you are waitlisted, select the service you are waitlisted for)

What kind of issue are you having:

A problem with my caseworker or staff at an agency, like a shelter or other place I receive services

A problem with my caseworker or staff at my apartment complex

A problem with my landlord

A problem with my neighbors or other community members

A problem with my caseworker or someone who works for Washington County or the Housing Authority

Something else (please describe below)

Have you already filed an official complaint or grievance on this issue somewhere else?

Yes

Send me a copy of my responses

Report Abuse

Housing Services﻿Grievance Submission Form

Housing Services
Grievance Submission Form