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About this form
Use this general checklist as a starting point when filing a grievance. Your facility sets the actual rules, forms and deadlines.
- Find your facility's grievance procedure (inmate handbook or posted rules).
- Note the deadline to file and each appeal deadline.
- State what happened: dates, people involved, and what you are asking for.
- Keep a copy of every form you submit.
- Record the date you filed and the date of any response.
- Complete each required appeal level if the response is unsatisfactory.
- If a form is refused or unavailable, write down who you asked and when.
Important: This is general information only and is not legal advice. It is not guaranteed to be accepted by any court, prison or agency. Always verify the current requirements with the facility, court, official agency, or qualified legal help before relying on it.
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