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DPS Ombuds Consultation Form
Thank you for contacting DPS Ombuds Office. Please complete this form to provide preliminary information that will help us determine how best to assist you. Your information and outreach will remain confidential.
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* Indicates required question
Are you a current DPS Employee?
*
Yes
No
Name
*
Your answer
Preferred (non-district) Email Address
*
Your answer
Cell phone or best number to reach you
*
Your answer
Title/Position
Your answer
What is your preferred form of communication? Please keep in mind that email is not a confidential method of communication. If you are concerned about confidentiality please select the phone call option.
*
Phone call
Email
How did you hear about us?
*
Ombuds Office Webpage
Presentation/Info session
Word of mouth
Flyer/Brochure
Recommendation/Referral
Other:
Required
If you selected "Recommendation/Referral" in the previous question, please select all options that apply
*
Supervisor/Manager
Human Resources (HR)
Legal department
Union/Staff Association
Not applicable
Other:
Required
Provide brief description of the reason why you are seeking Ombuds Office assistance (3-5 sentences)
Your answer
Please list 3 options with dates and blocks of time for your availability for a 1 hour consultation meeting during the week between 8:30am - 4:30pm (MST). Before and after hour appointments are available.
*
Your answer
Please select your preference for meeting type
*
Virtual meeting
Phone call
In Person
The meeting will be conducted in English. Would you like an interpreter for the meeting?
*
Yes
No
If you answered, "Yes" to the question above, please list your preferred language below.
Your answer
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