Dissatisfaction report

This document is not an official complaint , it is part of the process that may lead to a complaint, and does not require you to make a formal one, but shares with us your remarks on therapists or schools:

PART 1 – IDENTIFICATION

YOUR CONTACT INFORMATION

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Residential address
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CONTACT INFORMATION OF THE CONCERNED

Residential address

PART 2 – DESCRIPTION OF YOUR DISSATISFACTION

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In your procedure, have you already contacted, in writing or by phone: *

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Enter your signature

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