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Concern/Complaint Form
Please explain and give as much detail as possible when completing this form. The more details we have the quicker and more effectively we can work to address the concern or complaint.
Are you a . . . *
When did this event or situation happen? (date and time of day) *
Your answer
Where did the situation take place? (be as specific as possible) *
Your answer
Who is involved? (names or descriptions) *
Your answer
If there are witnesses, who are they? (names or descriptions)
Your answer
What was the event? What happened? *
Your answer
If you have already discussed your concern or complaint with any Grove teachers or staff, please state whom you reported to, the date it was reported, and the result.
Your answer
How would you categorize this event or what area would it fall under? Check all that apply. *
Required
Your name:
Leave blank if you would like this concern to remain anonymous.
Your answer
Your contact information:
Please provide a phone number or email address to be contacted. Leave blank if you prefer not to be contacted.
Your answer
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