Consumer Complaint Form

We ask that you contact the business first to try and resolve your complaint. If you are unsuccessful, you may fill out this form. Any other supporting documentation can be emailed to daconsumer@bouldercounty.org.

Please call 303-441-3700 with any questions or if you need assistance with this online form.


Consumer Information
Your Name:*  
Address:
City:
State:
Zip Code:
Home Phone:
Cell Phone:
Email:  
What is your age:

Business Information:
Name of Business:
Name of Person You Dealt With:
Address:
City:
State:
Zip Code:
Business Phone:
Business Cell Phone:
Business Email:

Complaint Information: Please keep all paperwork, correspondence and photos relating to your complaint. We will contact you when your complaint has been reviewed and may request to see those materials, which can be emailed to dacpd@bouldercounty.org .

1. Date of the purchase or service: *
 
2. What do you consider a satisfactory solution?
3. Have you contacted the business regarding the problem? *
 
4. Date of when you last spoke with the business?
5. What was the response from the business when you last spoke with them?
6. What was the total price of the purchase or service?
7. How much of the total price of the purchase or service did you pay?
8. What was the type of purchase or service? (Check One)
9. How did the exchange of money occur?
10. Is there a receipt or contract for the purchase or service?
11. Did you receive any written guarantee or warranty?
12. Please share any details about your complaint not covered above: