OPR Complaint Form

Instructions:

  1. Fill out the form as completely as possible, then click on the "Submit Message" button when done.
  2. Please provide a concise and detailed statement of the Compliment/ Complaint, including all relevant facts.
  3. Either print this page before sending for your records, or enter a valid return e-mail to receive an acknowledgement.
 
 
 
   
Name:
Street Address:
City:
State:
Zip:
   
Date:
   
Your Phone:
Your Email:
   
Witness 1 Name:
Street Address:
City:
State:
Zip:
   
Witness 2 Name:
Street Address:
City:
State:
Zip:
   
Witness 3 Name:
Street Address:
City:
State:
Zip:
   
Witness 4 Name:
Street Address:
City:
State:
Zip:
   
Incident Information  
Date:
Time
Employee Involved/Description:
Location
   
Description of Incident/Behavior:
 

 

Proclamation:
An individual making statements to an investigator of The Maine Department of Corrections regarding an investigation of an Administrative- Personnel Complaint or a criminal matter, does so with the understanding that any false statements, exaggerations, or deliberate omissions may be punishable as a Class D crime under Title 17A MRSA § 453.