complaint form

Complaint Form

Please complete and submit this form. You may remain anonymous if you choose to do so. However, if you do wish to remain anonymous, St. Matthews Fire & EMS may be unable to substantiate that a violation/problem occurred, if sufficient information is not initially provided. St. Matthews Fire & EMS would also be unable to follow-up due to the anonymity of the complaint. All types of comments are welcome, regardless of the nature of the comment. If for any reason (emergencies excepted - Call 911) you feel the need to contact us, please call our Headquarters at (502) 893.7825.

Complaint Information

* Indicates required field

Name *

First

Last

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Incident Information

Date *

Day *

Time of Incident *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Reason/Type of Employee Contact *

Nature of Complaint *

Remedy Sought *

Complaint Statement

Instructions: Please describe below, in detail, the incident about which you wish to complain. Please be as specific as you can about the persons involved and their actions.

Comment *

Submit

Complaint Form

Contact

Headquarters

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