Client Grievance/Complaint Form

Community Action Agency of Greater Kansas City clients are treated fairly without regard to race, color, sex, national origin/ancestry, religion, disability, veteran status, and any other characteristic protected by applicable affirmation laws. It is our intent to provide professional services to client who apply for individual programs we administer. If a client has a grievance/complaint he/she can submit their grievance through the CAAGKC website or through the front desk at one of the CAAGKC office locations. We will promptly follow-up with your concern(s). Thank you!
Your Information
Client Name*
First Last
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email
Alternate Phone
Best time to call*

: HH

MM
Grievance
Date of Incident*
MM
DD
YYYY
Time of Incident*

: HH

MM
Additional Information
Program Involved*
- Youth Services
- Supportive Services
- Healthy Homes
- Weatherization
- Other
Nature of Complaint*
Permission
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Security
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Your Information