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Submit a Complaint
SCCC recognizes the value and dignity of each person and the right to be treated fairly and with respect. As such, the Agency wants you to know that you have the right to submit a complaint at any time.
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* Indicates required question
Your Name (Optional)
Your answer
Your Email Address (Optional)
Your answer
Your Phone Number (Optional)
Your answer
What is your relationship to the Southern California Counseling Center?
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Board Member
Client
Donor
Employee
Trainee Counselor/Paraprofessional
Vendor
Other/Do Not Wish to Disclose
Please name the person(s) involved in your complaint.
*
Your answer
What is the nature of your complaint? [Please be sure to include the location, names of all parties involved, names of any witnesses, dates and details of the incident(s) that led to your complaint]
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Your answer
Did the incident(s) that led to your complaint happen to you?
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Yes
No
Other:
Has this incident(s) occurred before?
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Yes
No
Other:
Did you report the incident(s) to an Agency staff member, supervisor or manager?
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Yes
No
Other:
Please provide any additional information you feel is relevant to this complaint.
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Your answer
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