Compliance Complaint Form

Communication lines to the Compliance Officer shall be in place and accessible to all employees, persons associated with the Agency, and governing body members, to allow compliance issues to be reported. Such communication lines shall include a method for anonymous and confidential good faith reporting of potential compliance issues as they are identified.

If you are an employee or other stakeholder and wish to remain anonymous, please detail your complaint or allegation of violation below without including the identifying information requested in “Complainant Information”.  Please be aware that the failure to provide specific information may impede the full and complete investigation of this matter.

Non-retaliation Statement: To ensure employee cooperation, the William George Agency will not take any retaliatory action or retribution against any employee who has submitted a report of a suspected violation or who has participated in an investigation of a suspected violation in good faith.  Any employee who takes retaliatory action or retribution against another employee who has either reported a suspected violation or participated in an investigation of a suspected violation will be subject to disciplinary action.

If preferred: download and print the Compliance Complaint Form here and submit by mail or in person.

This form will be completed by the Compliance Officer for Verbal complaints or those submitted in other media (email, mail, voice message, etc.)

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