The Office of the Milwaukee Ombudsman for
Child Welfare Online Complaint Form
 

If you have an emergency regarding the safety of a child, call 220-SAFE because the Office of the Milwaukee Ombudsman for Child Welfare does not handle emergency situations.

Please note that the Bureau of Milwaukee Chile Welfare (BMCW) has a complaint process that can be used prior to completing this form and contacting the Office of the Milwaukee Ombudsman for Child Welfare. Please call 220-7063 for a copy of the BMCW Dispute Resolution Process.

Please fill out this form if you would like to make a complaint regarding a specific child and/or family involved with the BMCW (either currently or in the past). Please answer each question completely. The information you give us is used if it is determined a review will be conducted.

If you need assistance filling out this form, please contact the Office of the Milwaukee Ombudsman for Child Welfare directly at (414) 224-1347. We will help by answering questions and by helping you complete the form.

If we receive any information indicating a child is a risk for abuse or neglect, we will immediately inform the BMCW.

* indicates required field
How did you first hear about the OMOCW? (check one):
N/A-Resubmission   Relative
Service Provider   BMCW/Contracted Private Agency Staff
Court   Attorney
Guardian as Litem   Advocacy Group
Legislator   Official
Legal Aid   Health Care Professional
Website    Friend
Brochure-Location Obtained
Other (please explain)
Name of person who told you:
 
Your Information:
First Name:* Middle Initial:
Last Name:* Home Phone:*
Work Phone: Other Phone:
Address:* Apt/Suite:
City:* State:*
Zip Code:* Email:*
How would you like to be contacted?*  
 
Relationship to Complaint/Issue: (check all that apply) *
Self/Child Parent Relative
Legal Guardian Foster Parent Adoptive Parent
Guardian ad Litem Attorney BMCW Staff
Other :    
Please specify or explain checked boxes:
 
Complaint Summary: What is your Complaint?
Briefly describe the BMCW/Contracted Private Agency action or inaction that you are complaining about. Be sure to include the names(s) of the child(ren) and/or family as appropriate.
 
Case Information:
Parent Name: Date of Birth:
Parent Name: Date of Birth:
Child Name: Date of Birth:
Child Name: Date of Birth:
Child Name: Date of Birth:
Child Name: Date of Birth:
Child Name: Date of Birth:
 
Please describe why you think the BMCW/Contracted Private Agency action or inaction was wrong or unreasonable. (include as many facts as you can)
 
What do you hope will happen to resolve your complaint? (Please be specific)
 
What efforts have you made with the BMCW/Contracted Private Agency to address your complaint?
 
Who have you contacted or attempted to contact at the BMCW/Contracted Private Agency regarding your complaint?
 
Name: Site/Location/Agency:
Phone: Date of Contact:
What was the outcome?
 
Name: Site/Location/Agency:
Phone: Date of Contact:
What was the outcome?
 
Name: Site/Location/Agency:
Phone: Date of Contact:
What was the outcome?
 
Name: Site/Location/Agency:
Phone: Date of Contact:
What was the outcome?
 
Name: Site/Location/Agency:
Phone: Date of Contact:
What was the outcome?
 
Name: Site/Location/Agency:
Phone: Date of Contact:
What was the outcome?