Required fields are marked with asterisks (*)

Accessibility Feedback Report

The clerk's department shall investigate the feedback with the appropriate Department Head and ensure the person providing the feedback receives a response within seven (7) days

Reported by:

Contact phone number:

Your e-mail address:

Reported to:

Contact phone number:

Date of occurrence:

Date reported:

Type of feedback

Comment

Complaint

Description of event:

Action requested:

Personal information on this form is collected under the authority of the Municipal Act. It will be used as required for accessibility feedback. Questions about this collection may be directed to the City Clerk, City of Woodstock, 500 Dundas St., P.O. Box 1539, Woodstock, ON N4S 0A7