General Complaint Form First & Last Name Birthdate Ethnicity: –None–American Indian/Alaskan NativeArmenianAsianAsian IndianBlack/African AmericanCaribbeanCentral AmericanChoose not to IdentifyEuropeanHispanic/LatinoMiddle EasternMultiracialOther Racial GroupPacific IslanderPacific Islander/Native HawaiianSoutheast AsianWhite Gender: –None–MaleFemaleTransgenderNon-BinaryPrefer not to answer Phone Email Relationship to Child: –None–Adoptive ParentAttorneyCASACommunity MemberCWS StaffFatherFoster ParentGH StaffGuardianICWA AdvocateILP StaffJudgeLegal GuardianLegislative staffMaternal AuntMaternal GrandfatherMaternal GrandmotherMotherNMDOtherOther RelativePaternal AuntPaternal GrandfatherPaternal GrandmotherPlacement WorkerProfessionalProspective Adoptive ParentRelative Care ProviderSiblingSocial WorkerSocial Worker SupervisorSTRTP Staff Child's First & Last Name: (If you are reporting on a sibling group, only enter the oldest child’s name here.) Child's Date of Birth: (If you are reporting on a sibling group, only enter the oldest child’s birthdate here.) Tell us what you’re concerned about. (If you are reporting on a sibling group, enter the younger children’s names and birthdates here.) What would you like to happen?: Once you click “Submit” your form will be sent, you will receive an email confirmation and you will be redirected to the Foster Youth Ombudsperson homepage.