City Seats Feedback Form | Agenda for Children

Thank you for taking the time to share your feedback!

This form is a way to ask questions and provide feedback to Agenda for Children about children and caregivers’ experiences with publicly-funded New Orleans early care and education programs.

Please note: This form is NOT a substitute for reporting suspected abuse or neglect to the Louisiana Department for Children and Families. This form is also NOT a substitute for reporting suspected licensing violations to the Louisiana Department of Education. (Also note, this form does not substitute mandated reporting for those required to report suspected abuse or neglect.)

To report alleged abuse or neglect, please call 855-4LA-KIDS (855-452-5437).
Suspected licensing violations may be reported to the Louisiana Department of Education Division of Licensing at LDELicensing@la.gov or 225-342-9905.

For more information about mandated reporting, please visit the Louisiana Department for Children and Families website.

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City Seats Program Information

Please provide as much information as you can. The more details we have about your question or concern, the easier it will be for us to address the matter.

Which City Seats center does your child attend?(Required)

Please type the center name (and the address, if known).

Your Information (optional)

You do not need to provide information about yourself. However, if you do, we will be able to follow up with any questions and send you updates about a resolution.

Confidentiality Preference

I waive confidentiality. It is okay to release my name in order to investigate this concern.

I will provide contact information, but please keep my identity confidential.

Your Name

First Last

Your E-mail

Please provide an e-mail address where we can follow-up with questions and with more information.

Your Phone Number

Please provide a number where we can reach you if we need to follow-up.

Child's Name (if relevant)

First Last

Describe Your Concern

Provide as much information as you can about your question/concern, including the date and time of occurrence(s), classroom name (if relevant), and any other individuals who were involved.

Describe the concern with as much detail as you can:(Required)

Name(s) of other people involved or affected:

Have you reported this to anyone, including the City Seats Program staff?

Yes

If yes, please provide additional information.

What would you like to happen to resolve the matter?

Thank you for taking the time to share your feedback!

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City Seats Program Information

Your Information (optional)

Describe Your Concern

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