Complaint form

Section 1 : Identification

Name*

First name Last name

Full address*

Civic number and street City or community, Province Postal code

Email address*

Main telephone number*

Please note that the FNQLHSSC may contact you by telephone from Monday to Friday between 8:30 a.m. and 4:30 p.m. Please be sure to provide numbers where we can reach you during this timeframe.

Other telephone number

Complaint form

Section 1 : Identification

Section 2: Complainant

Section 3: Previous steps taken

Section 4: Details of the complaint

Section 5: Description of the facts

Section 6: Desired outcome

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