ACCREDITATION COMPLAINT FORM

Fields denoted by a * are required information

 

 

 

The Institute for Quality Management in Healthcare welcomes the opportunity to investigate all complaints received in writing from an identified source, as they may contribute to opportunities for improvement. If you wish to formally express dissatisfaction with an aspect of our Centre for Accreditation services, please provide a detailed description below.

 

If you wish to appeal an accreditation decision (assessed non-conformance decision or suspension or withdrawal of accreditation) please use the “IQMH Accreditation Appeal Form”.

 

Only complaints that are received in writing or on this form, with the identification of the complainant are investigated. If this complaint is being filed on behalf of a laboratory, the complainant’s facility name, IQMH site number and the licence number (applicable only to mandatory Ontario clients) must be provided, in addition to the complainant’s contact information.

 

If you are writing to file a complaint against a laboratory, please ensure that you follow the facility’s complaint process first.

 

 

Facility Name

IQMH Site Number

Licence number

Contact Name*

Contact Position

Contact Number*

Contact Email*

 

  Please provide a detailed description of your complaint below:*

 

Please note that by submitting this complaint you are agreeing for this information to be shared with all parties involved and the appropriate regulatory authority, if required.

The Executive Director, Programs will review the information above, and you will be contacted within 10 business days.

 

The “Submit” button allows you to submit the complete and final form.
IMPORTANT: Modifications cannot be made after Submit.

 

Version 3.1 (2018-10-19)