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Complaint Form

All of the information provided will remain confidential.

Personal Information:

Ms.

Mr.

Surname:

Given Name:

Address:

Apartment/Unit:

City:

Province:

Postal Code:

Phone - eg. (555) 222-1234:

Email:

Consent

I consent to being contacted via this email address. I acknowledge that the transmission of messages over the Internet is not secure and that emails may be intercepted:

I agree

I refuse

I consent to the disclosure of my name and a copy of this form to the institution concerned by my complaint for investigation purposes only:

I agree

I refuse

Personal information communicated to the Office of the Commissioner of French Language Services is collected in accordance with ss. 38 (2) of the Freedom of Information and Protection of Privacy Act. This personal information may be used for the purposes of investigations and reports arising from complaints received under ss. 12.2 of the French Language Services Act.

Information about the institution concerned

Name of the institution/organization concerned by the complaint:

Location of the institution in question:

Briefly describe your complaint. Explain what happened, providing the time, location, and individuals involved (if possible):

Suggestion for a resolution

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Follow-up

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Send your form to:
Office of the French Language Services Commissioner of Ontario
700 Bay Street, Suite 2401
Toronto ON M7A 2H8

Fax: 416 314.8331
Email: flsc-csf@ontario.ca

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