Form Submission Instructions
Please submit your inquiry/concern related to COVID-19 in the Inquiry/Concern Submission Form (Form) below. If you provide your contact information when filling out the Form, the Office of the Ombudsman (Office) will use best efforts to respond within two (2) business days.
The “First Name”; “Last Name”; “Phone No.”; “Email Address”; “DOC Facility Name“; and “Relationship with DOC Facility” boxes in the Form below are optional to allow for anonymous submission of inquiries/concerns.
Filling out the “Description of Inquiry/Concern” box is the only required text to submit the Form. Please be aware, the Office will not be able to respond to an anonymous inquiry/concern submitted without contact information. The Office reserves the right to screen out any unrelated/unverified inquiry or concern.
Please check the “YES, I AM WILLING” box if you consent to the Office sharing your name with the DOC. This will help us better facilitate a response to your specific inquiry/concern.
After completing the Form as desired, please click the blue “Submit” button to send your inquiry/concern to the Office.
If you have problems or questions related to this Form, please email the Office at firstname.lastname@example.org with the subject line “Question on Inquiry/Concern Form” and someone from the Office will be in touch shortly.
In the alternative, you can contact the Office via phone at 833-662-8410 to leave a message. Please listen to the instructions on the voicemail to leave a message, inquiry, or concern.
Inquiry/Concern Submission Form
Please be aware that, unless an exception applies, your inquiry will be considered a public record, which could be subject to production. See MGL c. 66, Section 10.
Please do not include any personal identifying information such as health or medical information in your message, as this is not an encrypted message format.
Any personal information submitted will not be used, published, transferred, sold or otherwise disclosed for any purpose that is not directly connected with this website or the Office of the Ombudsman except as provided by law or with the prior written consent of the individual or personal representative of the individual who is the subject of the personal information. Reasonable steps are taken to protect any personal information submitted from unauthorized use, access, disclosure, alteration, or destruction.