Detroit Wayne Integrated Health NetworkMonthly Recipient Rights Log

Detroit Wayne Integrated Health Network

Monthly Recipient Rights Log

Substance Use Disorder Department

Monthly Recipient Rights Log

Summary:

Briefly describe what happened, who was involved and what right was violated. State what you find the issues are and whether or not there are any underlying issues. What steps are going to be implemented.

Client/MHWIN ID 1

Reporting Month

Select

Agency Name

Email *

Phone Number*

Phone

Number of Clients Served

Number of Complaints

Submitter's Name

Person(s) Involved*

The name of the staff who received the complaint

Date of Incident*

The date the complaint was received

Complaint*

Briefly describe what happened, who was involved and what right was violated

Type of Complaint*

i.e. Policy and procedures, staff or physical environment

How Was the Complaint Resolved?*

Via, email, mail, in person, telephone

Formal / Informal*

All Informal complaints do not require an official written response. Abuse, Neglect and Unlawful acts should always be handled as formal complaints

Select or enter value

Issue*

State what you find the issues are and whether or not there are any underlying issues

Action Taken*

What steps are going to be implemented

Follow-up*

State if a follow-up is necessary. Do you require more time to investigate and reason

Completion Date*

The date the issue was resolved, did the findings support or do not support the allegations

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