Share a Concern/Complaint

SOME IMPORTANT NOTES ON CONCERNS/COMPLAINTS

As a volunteer, family, community partner or staff you have the right to make a formal complaint or share concerns; and to have that concern/complaint responded to in a fair, timely and considerate manner.
This form is provided for you to document your concern/complaint. You can use this form or you can write your concern/complaint in another format if you wish.
You can also make your complaint or share your concern verbally and a staff person will assist in writing it down.
You have the right to have an advocate or support person assist you in making your complaint or sharing your concerns.
We commit to no retribution/retaliation for filing a complaint or concern.

WHAT WILL HAPPEN AFTER YOU SUBMIT?

A Team Lead or Director will acknowledge receipt of the concern/complaint within ten (10) working days. The acknowledgement will be in writing and it will describe how we will act on your complaint or concern.
If you do not feel that the response is fair or appropriate or if the matter remains unresolved, you may ask for a review by the Executive Director. We ask that you make this request within one month of receiving the response from the Team Lead or Director.

Your full name

Your relationship to FSI

If 'other' please write your relationship to FSI below

List of all people involved in complaint/concern

Date incident/issue Occurred

mm/dd/yyyy

Explain your concern/complaint in your own words

Do your require cultural support from our IPA?

The Indigenous Practice Advisor (IAP) can provide cultural support to Indigenous (First Nation, Métis and Inuit) or non-Indigenous families, volunteers, community partners or staff.

YES

NOT APPLICABLE

How can we resolve your complaint/concern?

What would you like us to do to resolve the complaint or concern?

Please provide your contact information

As indicated by your preference above

Send me a copy of my responses

Report Abuse