This form is available for patrons to submit complaints to the Division of Gaming involving limited gaming. If you have a complaint related to or involving sports betting, complete the Sports Betting Complaint Form. Name and Date of Birth Your First Name Your Last Name Date of Birth Sex - None - Email Address Email Address Confirm Email Address Telephone Number Name of Casino Date and Time of Incident Date and Time of Incident: Date Date and Time of Incident: Time Name of Employee You Dealt With Narrative Narrative: In your words, describe in detail what happened. Be sure to state clearly what your complaint is. Tell us what you reported to casino management, and how they responded to your complaint. Identify by name or description all casino employees that you dealt with concerning this complaint. Tell us what you want to happen as a result of your complaint. I understand that this report is being made to peace officers of the State of Colorado and declare that all information provided with this submission is true to the best of my knowledge and belief. I further understand that if I have knowingly made false statements or intentional misrepresentations that I will be prosecuted according to law. Submit Leave this field blank
