File A Complaint

Nature of Complaint(Required)

Witnessed potentially criminal behavior by a city employee

Witnessed unethical conduct by a city employee

Experienced poor customer service

Disagree with a city policy/procedure

Want a local law or ordinance to be changed

Please Select One.

I Witnessed Potentially Criminal Behavior By A City Employee

Have you already filed a crime report with any law enforcement agency?

Yes

If yes, please provide the report or case number.(Required)

Drop files here or

Max. file size: 10 MB, Max. files: 2.

No, I have not filed a police report

Please report the crime you witnessed to a law enforcement agency by calling 911. Then return to complete this form using the report or case number provided to you by the investigating agency.

Date that potential criminal activity was witnessed(Required)

Date that criminal activity was reported to law enforcement(Required)

Name of witness/reporting person

First Last

Address for witness/reporting person

Street Address Address Line 2 City State ZIP Code

Phone for witness/reporting person(Required)

Email for witness/reporting person(Required)

Name of accused city employee(Required)

First Last

Witness account of incident

I Witnessed Unethical Conduct By A City Employee

Accusations of unethical conduct by staff may not be submitted anonymously, however, the name of the witness/reporting person will only be known to the Human Resources department and any law enforcement who may become involved if escalated to a criminal investigation.

Name of witness/reporting person(Required)

First Last

Phone for witness/reporting person(Required)

Email for witness/reporting person(Required)

Address for witness/reporting person

Street Address Address Line 2 City State ZIP Code

Name of accused city employee

First Last

Date that potential unethical conduct was witnessed(Required)

Witness account of incident

What, if any evidence do you believe should be reviewed as part of any investigation

Specific documents, video evidence, other documentation?

I Experienced Poor Customer Service

Please provide your name and contact information so we may contact you regarding your experience if so desired.

I want to be contacted regarding my experience

Yes

Name

First Last

Phone

Address

Street Address Address Line 2 City State ZIP Code

Date the unsatisfactory experience occurred

Department you were working with

Name(s) of employee(s) you were working with

Tell us about the unsatisfactory experience:

Please describe the narrative of events with as much detail as possible

How you believe we should have handled the situation

I Disagree With A City Policy/Procedure

At times, it is possible that our staff do everything they can within the law and internal policies to satisfy a customer, however, city policies and/or procedures result in a dissatisfactory experience for the customer, despite staff’s best efforts to provide high-quality customer service. If this was the case and one of our employees informed you of a specific policy with which you disagree, we may conduct a review of the policy in light of your particular situation which may result in a change of policy.

First, please provide your name and contact information so we may reach out to you to learn more about the circumstances as part of a policy review.

Name

First Last

Phone

Address

Street Address Address Line 2 City State ZIP Code

Please explain the situation which left you dissatisfied and provide us with details to the following questions so we may conduct a review of the relevant policy.

Department you were working with

Name(s) of city employee(s) you were working with

Please describe the situation

Please describe the policy as it was described to you

Do you feel you understand the purpose of the current policy?

Yes

Please describe what you believe would be a reasonable change to the policy

I Want A Local Law or Ordinance to be Changed

If you would like city council to consider a change to the city code of ordinances, please complete the following form. Upon submission, this form will be sent to the City Administrator and the two council members which represent your district. There are three council districts in Nixa, so we need to know your address in order to know which council members represent you. If you prefer, you may find contact information for your council members at this page on our website: https://www.nixa.com/mayor-council/ You may then discuss your concerns with your council representatives directly. You may also attend any city council meeting and address the council during the visitors’ section or relevant public hearing on the meeting agenda. This form is provided simply as a convenience if you choose to voice your concerns in this manner.

First, please provide your name, address, and contact information so we may get in touch with you regarding your concern

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Which district do you reside in?

District 1

District 2

District 3

Phone

Please describe the municipal ordinance which you would like for the city council to consider changing, explain why you would like the ordinance changed, and what you think would be a better, more reasonable solution

Keep in mind, city council cannot pass any ordinance which would conflict with state or federal law

This field is for validation purposes and should be left unchanged.

Fix It Request

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