Client Feedback Form - Thresholds Homes and Supports

Full name:

Pronouns:

Phone number and/or email address to reach you:

This issue about Thresholds Homes and Supports' (please check box):

This issue is about (please check box):

Personal damage e.g. personal injury, property damage A disturbance of my reasonable enjoyment as defined by the Residential Tenancies Act (RTA) or applicable bylaws Other

Date of concern:

Time of concern

If known, please provide the first names, last names, and descriptions of all people involved:

Please list any THS staff you would like to receive a copy of this complaint:

Please describe what happened during the incident:

What did you do to try to resolve the problem:

If there were witnesses, please provide names or descriptions below:

Were there cameras in the area?

Were police involved?

If there were police involved, please share the occurrence number if you have it:

I understand that because of confidentiality and the Personal Health Information Protection Act, representatives from Thresholds Homes and Supports (THS) may not be able to tell me the actions they have taken as a result of this report. I understand that other staff may be consulted to help resolve my concerns. 

All Client Complaint Forms are shared directly with Thresholds Homes and Supports’ Data and Quality Systems Manager for review and follow up as appropriate. We may reach out to you for additional information.

Client feedback and complaint form