FAMILY LAW FACILITATOR COMPLAINT FORM Our staff is committed to providing you with the highest quality service. The Family Law Facilitator is here to assist you with the legal procedures regarding your Family Law case. If you feel you did not receive high quality service from the Facilitator, please let our court know by completing this complaint form. Answer all questions, including those on the reverse side of this form, and return the form to the Family Law Clerk's Office located in the same building where the Facilitator helped you. Your complaint will be reviewed thoroughly by the Court Executive Officer and someone from that office will contact you with a response. Please be sure to include a telephone number where we can contact you in case we need further information about your complaint. This form will not be placed in your Family Law case file. Filing a complaint against the Facilitator will not affect the outcome of your Family Law case. Name: Address: Daytime Telephone: Today's Date Case Number: Name of the Family Law Facilitator: Date of Complaint: What is your cornplaint? Please be specific. If necessary, continue on the reverse side or attach more pages. MER-0016 Rev. 4/23/03 FAMILY LAW FACILITATOR COMPLAINT FORM Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com How can the Court assist you in resolving your complaint? For Court Use Only: Date Complaint Received by CEO Date Complaint Reviewed with Facilitator Client Contacted for Add'tl Info: Yes (date) or No Resulting Action: Client Informed of Result: Yes (date) MER-0016 Rev. 4/23/03 or No FAMILY LAW FACILITATOR COMPLAINT FORM Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com