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Civilian Complaint

  1. Instructions For Completion of Form

    Please answer all questions completely. If you have a complaint against multiple employees please submit this form for each employee. The submission of this form triggers an internal review by the Brookline Police Department Office of Professional Responsibility.

  2. Need Translation? Change Language at bottom of page.

  3. 1. COMPLAINANT INFORMATION

  4. Complainant Information*

    Are you will willing to identify yourself?

  5. 2. INCIDENT INFORMATION

  6. Previous Contacts with the Accused Employee(s):

  7. Other Evidence Or Documentation To Support Allegations:

  8. 3. Witness Information

    Please identify all witnesses (for example, eyewitnesses) whom you believe possess information relevant to the complaint.

  9. 4. Complainant Injuries

    Please describe all injuries as clearly as possible.

  10. Injuries Claimed:

  11. Injuries Visible:

  12. Doctor or Hospital Visited:

  13. Photos or Other Documentation Taken of Injuries:

  14. Willing To Release Photos or Other Documentation:

  15. Willing To Provide Medical Records:

  16. 5. INCIDENT NARRATIVE

    Describe incident in detail giving specific times, dates, locations, witnesses, conversations and actions.

  17. If you have previously provided a written narrative of the incident, i.e., email, letter, of the incident, do you wish this submission to serve as your narrative:

  18. 6. CONFIDENTIALITY

  19. Please specify any information that you wish the Department to maintain confidentially, to the extent doing so is permissible under the law.

  20. I have reviewed the Brochure and Written Explanation of Citizen Complaint Procedures Provided to Complainant

  21. Leave This Blank:

  22. This field is not part of the form submission.