Office of the Independent Ombudsman

Ombudsman Request Form

Complete the online form below, which will be sent to the Office of the Independent Ombudsman.

Requestor Name:

Relationship to Inmate:

Address:

City:

State:

ZIP:

Phone Number: () -

E-mail:

Grievance (Select up to 3)

Ctrl+click to select multiple

Text Check: leave this field blank:

Inmate Name:

TDCJ Number or Date of Birth: (optional)

Unit Currently Assigned: (optional)

Date and Unit of Incident: (optional)

View the TDCJ privacy and security policy regarding information submitted via this form.