Welcome to the California Department of Alcohol and Drug Programs Welcome to the California Department of Alcohol and Drug Programs
     
Decrease the text size Restore original text size Increase the text size
Enlarge Text
Click to increase the text size.
Restore Text
Click to restore original text size.
Reduce Text
Click to decrease the text size.
ADP Logo
STATE OF CALIFORNIA-HEALTH AND HUMAN SERVICES AGENCY
Jerry Brown, Governor

state seal DEPARTMENT OF ALCOHOL AND DRUG PROGRAMS
Office of External Affairs
1700 K STREET
SACRAMENTO, CA 95811-4037
TDD (800) 735-2929


COMMENT/COMPLAINT FORM

Section 8331(a) of the Government Code requires that State Agencies provide a form through which individuals can register complaints or comments relating to the performance of that Agency.
PERSON FILING COMMENT/COMPLAINT:


  WHICH ADP DIVISION/PROGRAM IS YOUR
  COMMENT/COMPLAINT ABOUT?




  ADDRESS (Number and Street):



  PERSON WITH WHOM YOU DEALT:



  CITY, STATE, ZIP:



  LOCATION OF ABOVE:



  TELEPHONE NUMBERS (daytime, with area code):



 FAX NUMBER/E-MAIL ADDRESS (if any):



 STATE YOUR COMMENT/COMPLAINT (Be specific - who, what, when, where, how; attach additional pages if needed):













  HAVE YOU CONTACTED US BEFORE ON THIS MATTER? WHEN? WHO WAS YOUR CONTACT?






 SIGNATURE ______________________________________   DATE__________________________

All information provided to ADP is confidential and subject to the Privacy Act of 1974