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My Healthy Community: Community-Level Health Data

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LTC Complaint Form

*In order to submit a complaint all following field sections are considered mandatory. Please fill in all information pertaining to the occurrence before submitting the complaint. This will help us know how to contact you and accurately look into the occurrence.

Reporting Person:





Facility





Occurrence Detail









Resident(s) Involved:




Involved Person(s)



Witness(es):







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