Complaint Record Form Details of person making the complaintDate complaint received *Name of person receiving complaint *PositionDoes the person making the complaint wish to remain anonymous? *YesNoIf no, name of person making complaintCategory of person making complaintParticipantFamily memberFriendGuardianManagerOther providerStaff memberOtherPreferred method of contact *PhoneEmailLetterPhoneEmailPostal addressParticipant detailsName of participant complaint is regarding *(if participant is not the person making the complaint)Is the participant an existing client? *YesNoCan we speak to the participant about this complaint? *YesNo(if complainant is not the participant)Complaint detailsDescription of complaintWhat is considered appropriate resolution by the person making the complaint?Current status of complaintInvestigatingAction proposedResolvedUnresolvedWhat actions have been proposed? Or if resolved, how was it resolved?Submit
