How Do I File a Grievance?

You do not have to be a client to file a grievance. Anyone can report allegations of professional misconduct or problems with the agency. You should first attempt to resolve your complaint or grievance with the service area associated with the compliant. If this is not possible, then follow the process outlined below.

If you have any questions regarding the process, please contact Sr. Director of HR Patricia Forsyth at [email protected].

Our office will review all submitted grievances and may conduct an investigation. If an investigation is conducted, the results of the investigation will be shared with you in writing. All submissions are kept confidential, and only shared with stakeholders that have a right to know. This information will be used to make improvements to agency services and processes.

I Am Not a Client But Wish to File a Grievance:

I Am a Client And Wish to File a Grievance:

There are two methods for a client to complete a compliant or grievance:

Formal Grievance

This written method requires you to complete the CCIEC Client Rights Complaint/Grievance form. This is the preferred method of contact since it incorporates all the necessary questions to complete the process. Simply complete and submit the electronic form below.

Informal Grievance

This method is where you can verbally express your complaint/grievance. If you are going to use this method, please contact: Sr. Director of HR Patricia Forsyth at [email protected].

Client Rights Formal Grievance Form

If you live in Michigan and believe that one of your rights has been violated, you may use this form to file a formal grievance. Our office will review all submitted grievances and may conduct an investigation. If an investigation is conducted, the results of the investigation will be shared with you in writing. Please contact Sr. Director of HR Patricia Forsyth at [email protected] if you have any further questions.

First Name

Last Name

Street Address

City

State

Postal Code

Email Address

Phone Number

Children's Home Unit Name

Is someone filing the grievance on behalf of the client? If so, please provide your contact information below. Is someone filing the grievance on behalf of the client? If so, please provide your contact information below. Yes, I am filing this grievance on behalf of the client. No, I am the client.

First Name

Last Name

Relationship to Client

Street Address

City

State

Postal Code

Phone Number

Email Address

Children's Home Unit Name

Date of Alleged Violation (required)

Location of Alleged Violation (required)

What right was violated? (required)

Is this grievance about a CCIEC staff member? (required) Is this grievance about a CCIEC staff member? (required) Yes No

If yes, what is the CCIEC' staff member's name?

Please describe your grievance. (required)

What would you like to see happen in order to correct the problem? (required)

I declare that all statements contained in this submission are true and that any misrepresentation or omission may result in rejection of my grievance. I declare that all statements contained in this submission are true and that any misrepresentation or omission may result in rejection of my grievance. Yes No

I acknowledge that typing my name in the box below certifies my signature and submission of my grievance. I acknowledge that typing my name in the box below certifies my signature and submission of my grievance. Yes No

Client Signature (required)

Date (required)

Name of person assisting client (if applicable)

10 + 15 =

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