Who this letter is for

This template is for filing a formal complaint with the Commissaire aux plaintes et à la qualité des services (CPQS) at your regional health authority (CIUSSS/CISSS). Use it when informal attempts to resolve an issue have not succeeded.

You should have first attempted to resolve the matter directly with your care coordinator or CLSC management before using this formal process.

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[Your name]
[Your relationship to the person receiving care]
[Your phone number and email]
[Date]

To: Commissaire aux plaintes et à la qualité des services
[Name of CIUSSS/CISSS]
Re: Formal Complaint — [Name of Person Receiving Care, Date of Birth]

Dear Commissaire,

I am writing to file a formal complaint regarding the home care services received (or not received) by [full name], a client of [CLSC name].

Description of the situation:
[Describe clearly what happened, including dates where possible. Explain what you requested, what the CLSC decided, and why you believe the decision was incorrect or the treatment was inadequate.]

Steps already taken:
On [date], I spoke with [name of care coordinator or supervisor] regarding this matter. [Describe what was said and what response you received.] The situation was not resolved to my satisfaction.

What I am requesting:
[State clearly what you want as an outcome — e.g., a new assessment, reinstatement of a cancelled service, a written explanation of the decision, an apology.]

I am requesting that you investigate this matter and respond to me in writing at your earliest opportunity.

Please acknowledge receipt of this complaint.

Sincerely,
[Your name]
[Date]

Attachments:
[List any documents you are including — e.g., copy of care plan, prior correspondence, caregiver journal excerpt, falls record]

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What to expect

The CPQS is required to acknowledge your complaint and respond within a legally mandated timeframe. If you are not satisfied with the CPQS's response, you can escalate to the Protecteur du citoyen.

Keep copies of all correspondence throughout this process.