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Internal Complaint Form

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    Request for Internal Complaint Review Panel

 
Please complete the form below and click Submit to send it to Peel CAS. If you prefer to mail the form, click here for a Complaint Form PDF.
 
Name:
Email:
Relationship to child:
Child's name:
Child's date of birth:

I am making a complaint to the Children's Aid Society of the Region of Peel relating to a
service sought or received from the Society by me.
(Complaints relating to an individual, an issue decided by or currently before a court or tribunal, or
decision making process under the Child and Family Services Act, or the Labour Relations Act are not
eligible for review.)

My preferred method of contact is:
Phone
  • I give permission for a representative from Peel CAS to call me to discuss my concern
  • I give permission for a representative from Peel CAS to leave a voice mail
Email
Mail

Which of the following is an accurate summary of your concern? (Check only those that are
applicable)
I was not given the opportunity to be heard by the Society regarding my concerns about
the above services that I was receiving. (Please briefly outline below the services
sought or received and the circumstances of not being heard.)

I was not given the opportunity to be heard and represented by the Society when
decisions affecting my interests were made. (please briefly outline below the decisions
and the circumstances of not being heard)

I was not given reasons by the Society for a decision that affects my interests. (Please
briefly outline below the decisions and the circumstances of not receiving reasons)

There is an alleged inaccuracy in the society's files or records regarding me. (Please
indicate below the alleged inaccuracy)

Please note that it is your right to place a Notice of Disagreement on the Society's records regarding the alleged
inaccuracy.

Please provide a concise summary:



What is your desired outcome for the complaint process?



Do you have suggestions on how the Society can assist and/or work with you to ensure the protection, well-being and best interest of your child(ren)?