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2. If you prefer not to use an online form you may call 513-677-7000 to speak with the supervisor on duty.
4. Last Name
5. First Name
7. Address
9. City
10. State
11. Zip Code
13. Phone Number
14. Email Address
18. Date of Occurrence
    Date of Occurrence Start Date

    —

    Date of Occurrence End Date
19. Time of Occurrence
    Time of Occurrence Start Time

    —

    Time of Occurrence End Time
21. Location of the Occurrence
23. Please Describe the Situation*
25. Perception of this Situation?
    -- Select One --PositiveNegative
26. Name of the Officer Involved
28. Thank you for your feedback. You should expect a response within 72 hours.
30. Under Ohio Revised Code 2921.15 it is a criminal offense to make false allegations of peace officer misconduct
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32. 1. Receive an email copy of this form.
33. Email address

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