Detroit at Work Customer Service Report
Email *
First Name *
Last Name *
Date of Birth *
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Phone Number *
Where did the issue that concerns you take place? *
If you chose other in the question above, please describe below:
Approximately, when did this event take place?  *
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Do you recall the name of the person you spoke to?  *
If you answered yes in the question above, can you enter the person's name below?
Please describe the incident, any details you recall (such as names, dates, or locations) and any concerns that you have encountered since the event: *
A copy of your responses will be emailed to the address you provided.
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