Complaint Form

Personal information disclosed is CONFIDENTIAL

IDENTIFICATION OF THE PERSON:

Name:

First Name:

Full Address:

Postal code:

Residence Telephone:

Cellular:

Email:

Office Phone:

PARENT IDENTIFICATION (if applicable):

Name:

First Name:

Full address:

Postal code:

Residence Telephone:

Cellular:

Office Phone:

COMPLAINT (complete the following information):

Service:

Mediation

Victim consultation

Restitution

Financial compensation

Letter to the victim

Resource orientation/referral

Other :

Employee Name (if applicable):

Fonction:

SUBJECT-MATTER OF THE COMPLAINT:

Please describe in detail the facts, events, circumstances or actions relating to the complaint.

YOUR EXPECTATIONS FOLLOWING THIS COMPLAINT:

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Reminder

The organization undertakes to deal with your complaint within 30 working days upon receipt of the complaint.

Complaint Form

IDENTIFICATION OF THE PERSON:

PARENT IDENTIFICATION (if applicable):

COMPLAINT (complete the following information):

SUBJECT-MATTER OF THE COMPLAINT:

YOUR EXPECTATIONS FOLLOWING THIS COMPLAINT:

Reminder

Resources

Our philosophy

Get in touch quickly
with our organization!

IDENTIFICATION OF THE PERSON:

PARENT IDENTIFICATION (if applicable):

COMPLAINT (complete the following information):

SUBJECT-MATTER OF THE COMPLAINT:

YOUR EXPECTATIONS FOLLOWING THIS COMPLAINT:

Reminder

Resources

Our philosophy

Get in touch quickly with our organization!

Get in touch quickly
with our organization!