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Filing a Concern and/or Complaint
Do the Following:
Inform a CODIE employee who can relay your concern to a program supervisor.
Request a meeting with a program supervisor or the CEO in person or on VP.
File a complaint. Click below for a copy of our complaint policy and procedures.
First Name
Last Name
Email
Address
Address Line 2
City
State / Province / Region
Zip Code
Phone/ VP
Phone Type
Voice
Videophone
Fax
TTY
Your Grievance
A grievance is a complaint made by a client or a community member against a service, staff or policy of GLAD. A grievance must be made within 30 days of the incident. If you cannot complete this form, you may request a meeting with a GLAD program manager who will complete the grievance form for you.
Which Agency are you filing grievance?
GLAD
OCDEAF
CODIE
TCGLAD
B-GLAD
Please type what happened in the box below
Incident Date
Incident Time
Location of Incident
Name(s) of Staff involved, if any
Name(s) of witnesses or other persons involved
Do you have documents you want to upload? (Max. file size: 64 MB)
What actions do you want in response to your grievance?
Change in service or policy
Establish new service or policy
Attention to staff performance
Select All
Other
If your response is "other", please explain what you want in response to your grievance?
Type in your name as your signature
Signature Date
Submit
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