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Complaint Form
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Children’s Treatment Network of Simcoe York (CTN) Complaint Form
First Name:
Last Name:
Address:
City:
Postal Code:
Home Phone:
(
)
-
First three digits
Second three digits
Last four digits
Work / Cell Phone:
(
)
-
First three digits
Second three digits
Last four digits
Email:
Do you need an interpreter? :
Yes
No
Please describe your complaint:
(provide detail about what happened, time and location, and who was involved)
When is the best time to contact you?:
Is there anything else we need to know:
Note: We will be in touch with you within 7 business days. If you prefer not to write about your complaint, please call 1-800-719-4795 Ext. 72381 (Local: 905-773-4779 Ext. 72381)