Crisis Hotline (800) 317-0708

Rights Complaint Form

Over 3 months I have got my own place, improved my attitude, my life goals and choices to improve our life.
-Clare County

Online Recipient Rights Complaint Form
Complainant's Name*
Recipient's Name
(if different from complainant)
Phone Number*
Address
Where did the alleged violation happen?*
When did it happen?*
(Date and time)
What right was violated?
Describe what happened*
What do you want to have happen in order to correct the problem?*


*Denotes required information.

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share, lease or rent any personally identifiable information to any third
party not specifically authorized by you to receive your information.

Over 3 months I have got my own place, improved my attitude, my life goals and choices to improve our life.
-Clare County
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