Administrative Review & Risk Management Division

Inmate Grievance Program - Complaint Form

Requestor Name:

E-mail:

Inmate Name:

TDCJ# or SID#: TDCJ SID

Has the inmate filed a grievance on this incident? Yes No

Grievance Number (If known)

Text Check: leave this field blank:

Describe your complaint

All fields required unless noted. View the TDCJ privacy and security policy.