Click for Client Grievance Guide NameIf name not provided this may limit us in our ability to resolve grievance First Last Program(Required)Bright Start ChildcareNurturing Parenting ProgramParents as TeachersDoulasMental Health Juvenile JusticePositive Parenting ProgramWraparoundCounseling & Wellness CenterIn-Home-IntensivePositive Parenting ProgramFoster CareTransitional & Independent LivingYouth HomeGroup HomeOtherWhat are you filing a grievance/complaint about?Recommendations may not be the final solution.What right(s) have been violated?You can select multiple options Freedom from abuse/neglect Adequate/humane care Privacy Appropriate treatment services Confidentiality Right to possess property Right to refuse services Right to file a grievance Notification of right restrictions Right to accommodations Freedom from exploitation Not treated with respect/dignity Right to mail/phone/visits or right to review file Language/communication rights Receive services without discrimination Contact Guardianship, Advocacy, or Placement Agency Rights guaranteed by law Active in treatment planning Notification of med side effects Appropriate use of restraint/seclusion I don't know Other (please explain below)OtherWhat would you like to see happen in response to your grievance/complaint?
