Fill this form to Report Poor Service

Personal Information:

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Do want to specify your personal information?

Enter your name as it is written on you National ID

Enter your valid Phone number
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Select the year you were born

Service Details

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Select category of poor service related


Did someone request corruption from you?


Add the Suspect name if you know him/her

Add the Suspect phone number if you know him/her
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Select province from which the service delivered
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Select district from which the service delivered
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Select Station from which the service delivered
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Add the date on which you received the service
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Add the summary of how services was, (max characters 1000)
1000/1000

Add the Recommendation of how services was, (max characters 1000)
1000/1000

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Please, check the box below to confirm that you are human, not robot.