The City of Hamilton strives to improve accessibility for our residents and visitors with disabilities. We welcome your feedback, comments, questions, complaints and suggestions about the provision of our goods, services and programs to persons with disabilities. Thank you. Answers to fields and questions with an asterisk ( * ) are mandatory This is a: * Complaint Compliment Suggestion Question Date Year Year20152016201720182019 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Description of your concern, complaint or suggestion: * For complaints/concerns, please include the location and date the incident occurred. Your Information: Name: Address: Email: Telephone: Fax: Other: Would you like us to inform you of the outcome of your feedback? * Yes No How would you like us to contact you? * Telephone Email Fax Postal mail In-person Other (please specify) Other * Special Instructions (support needed for communication, etc.) * None Accessible hearing or listening devices Bell Relay Large print Other Other support Personal information on this form is collected under the authority of Section 238 of the Municipal Act, 2001, S.O.2001, c.25 (as amended) and will be used to respond to the feedback provided and for reporting requirements pursuant to O/Reg. 429/07 Customer Service Standards. Questions about this collection should be directed to:Human Rights, Diversity and Inclusion 120 King Street West, 9th Floor, Hamilton, ON L8P 4V2 Tel: 905 546 2424 Ext. 8080 Fax: 905 546 2062 Email: aoda@hamilton.ca Date modifiedd: 2015-06-24
