All service recipients have the right to file a grievance if they believe that any policy has been unfairly applied to them, or that they and/or their children have been mistreated by any Hope House personnel.

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* 1. Please select one of the following options:

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* 2. Name

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* 3. Safe Contact Phone Number

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* 4. Safe Email Address

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* 5. What would you like to report?

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* 6. Name of the alleged violator, if known.  

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* 7. What is the problem and/or concern you want to report?  Please provide a description of the facts and circumstances surrounding the reported activities, including evidence forming the basis of this report.  Include specific information, including the date of the event and/or a timeline of events that led to this grievance.

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* 8. When and how did you become aware of the problem?  Please identify potential witnesses and their involvement and any corrective action taken by you, the company, or any other entity.  

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* 9. How long has the problem existed?

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* 10. When was the most recent occurrence of this problem?

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* 11. Is there any additional information that might be useful to us in evaluating this complaint?

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* 12. What is your desired outcome?  

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