COMPLAINT INTAKE FORM

If you think the City of Leon Valley is not in compliance with the law, you may submit this complaint form. Once submitted, the Human Resources Office will acknowledge receipt and investigate. Complaints are limited to buildings and facilities owned or operated by the City of Leon Valley. If the complaint involves a facility owned or operated by Bexar County, the City of San Antonio, or another government entity, please direct the complaint to the appropriate office.

The Human Resources Office will verify for qualification under the Texas Women's Privacy Act. Verified complaints will be investigated, and a thorough review will be conducted. You may be contacted if questions arise or additional information is required. If it does not qualify, you will be notified.

Confidentiality Notice: The City of Leon Valley cannot guarantee the complaint information will remain confidential. The Texas Public Information Act allows the public release of any information held by the City of Leon Valley. Your name and complaint may be made public if the City of Leon Valley receives a request for the information.

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COMPLAINANT'S INFORMATION

First Name *

Last Name *

Phone Number *

Mailing Address *

City *

State *

Zip *

Email Address *

INCIDENT REPORT

Date of Incident

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Time of Incident *

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Time of Incident AM

Time of Incident PM

Name of City Facility *

Address/Location of City Facility *

Description of why you believe the City facility reporting is not in compliance with Senate Bill 8 *

OTHER REPORTS OF INCIDENT

Did you report or discuss this complaint with a City representative? *

Yes

If yes, provide the following information:

Name of City Representative *

Title of City Representative *

Date of report/discussion with City Representative

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COMPLAINT INTAKE FORM

Contact Information