Client Complaint/Grievance

Name(Required)
Address(Required)
MM slash DD slash YYYY
Describe the nature of the grievance/complaint. Be specific, including identification of those involved and any witnesses.
In your opinion, what needs to be done to resolve this matter?

Persons served, family members, or advocates may file a grievance or complaint without fear of threat or reprisal in any form. Please fill out, date, and sign this form and submit it to the Sinnissippi Centers office receptionist or mail to Sinnissippi Centers, Inc., Customer Services, 325 Illinois Route 2, Dixon, Illinois  61021. You will be provided with a response within thirty (30) calendar days of our receipt of this report.

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