Patron request for reevaluation of library materials

Please take time to complete the following form to help us understand your concerns. It is important for you to provide contact information, so that we may follow-up with you.

Contact information
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Are you representing:
- Self
- Organization or group
If representing an organization or group, please identify:
Material
Title
Publisher
Date
Enter the date the book was published
Date Format: MM slash DD slash YYYY
Additional required information
How did you learn about the material in question?
How much of this material did you read and/or examine?
Have you read any reviews of the material?
- Yes
- No
If yes, please indicate the name of the reviewer and/or the publication in which it appeared.
What do you believe is the theme of the material?
What specifically is objectionable about the material? Please be specific and cite pages.
What do you feel might be the result of reading, seeing or listening to this material?
Is it suitable for some age groups?
Is there anything worthwhile in the material?
What would you like for us to do about this material?
What substitute would you recommend to replace the material?
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Patron request for reevaluation of library materials

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Material

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Patron request for reevaluation of library materials

Contact information

Material

Additional required information

You have questions. We have answers. We're librarians. (It's what we do.)

You have questions. We have answers.
We're librarians. (It's what we do.)