Kiwassa Neighbourhood House Feedback Form

Please use the form below to submit a thank you or complaint directly to Kiwassa.

All responses will be reviewed by the Quality Assurance Team within 5 business days. You will receive communication, in the method of your choice, within these 5 business days from the day that the feedback was submitted. A Kiwassa employee may contact you for additional details about your praise or complaint.

Personal information is collected for the purpose of processing the feedback provided in accordance with Kiwassa's Complaint Policy and Participant Rights and Responsibilities Policy.

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* 1. What is your connection to Kiwassa Neighbourhood House?

Kiwassa Community Member (program participant)

Kiwassa Team Member (staff)

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* 2. Please provide your first name in order to follow-up with your response.

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* 3. Please provide an email address or phone number to contact you. Follow up will be provided in 5 business days.

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* 4. Would you like help to finish this form?

Yes