Complaint Record Form

An official website of the City of Los Angeles

Use this form to report a concern regarding the conduct, professionalism, or service provided by a member of the Los Angeles Fire Department.

Submitting a Complaint
The Los Angeles Fire Department takes complaints and concerns seriously. Information submitted through this form may be reviewed by Professional Standards personnel and may be used for follow-up purposes.

Important: Do not use this form to report an emergency or request immediate assistance. For emergencies, call 9-1-1.

Incident Information

Date of Incident *

Approximate Time

Incident / Event Type

Location of Incident *

Incident / Report Number

Employee / Unit Information

Employee Last Name

Employee First Name

Badge / Employee Number

Unit Number

Station

Unit Type

Nature of Complaint

Employee Conduct Professionalism Service Provided Communication Treatment / Interaction Other Concern

Complaint Details

Describe Your Concern *

Reporting Party Information

Full Name *

Email Address *

Preferred Contact Method

By submitting this form, I certify that the information provided is accurate to the best of my knowledge. I understand that the information may be reviewed by Department personnel for administrative and Professional Standards purposes.

Electronic Signature *

LOS ANGELES FIRE DEPARTMENT

Complaint Record Form