Complaint Form

[et_pb_section fb_built=”1″ background_color=”#e8e8e8″ custom_padding=”38px|0px|39px|0px” admin_label=”section” _builder_version=”3.0.47″ background_image=”https://simac.ca/wp-content/uploads/2017/03/surveys-1.jpg” custom_css_main_element=”backgound-color:#eee;”][et_pb_row make_fullwidth=”on” background_color=”rgba(0,0,0,0)” parallax_method_1=”off” admin_label=”row” _builder_version=”3.0.47″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”4_4″ _builder_version=”3.0.47″ parallax=”off” parallax_method=”off”][et_pb_post_title meta=”off” featured_image=”off” text_orientation=”center” module_bg_color=”rgba(255,255,255,0)” admin_label=”Post Title” _builder_version=”3.0.47″ title_font=”|||on|” title_font_size=”42px” custom_padding=”40px||40px|”] [/et_pb_post_title][/et_pb_column][/et_pb_row][/et_pb_section][et_pb_section fb_built=”1″ admin_label=”Section” _builder_version=”3.0.47″][et_pb_row admin_label=”Row” _builder_version=”3.0.47″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”][et_pb_column type=”4_4″ _builder_version=”3.0.47″ parallax=”off” parallax_method=”on”][et_pb_text admin_label=”Text” _builder_version=”3.0.51″ background_size=”initial” background_position=”top_left” background_repeat=”repeat”]

Complaint Form

If you wish to file a formal complaint with SIMAC, you may do so by completing this form. You may also opt to contact us by telephone, or in writing via email or letter to express your concerns. Please provide as much information as possible so that we may address your concerns promptly and efficiently.

Your Contact Information
Name:
First Last
Date of Birth:
Month
Day
Year
Email:
Phone:
Address:
Street Address Address Line 2 City Province Postal Code
Complaint Details
Date of Incident:
Month
Day
Year
Time of Incident:

: Hours

Minutes

AM/PM
Location of Incident:
Name of Witness:
Witness Telephone:
Name of Witness:
Witness Telephone:
Description of Incident:

[/et_pb_text][/et_pb_column][/et_pb_row][/et_pb_section]