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GRIEVANCE FORM

If you have a specific issue you want brought to the attention of program management for investigation or if you believe you have experienced unjust, unethical, discriminatory or illegal treatment, please use this form to file a grievance. 

​Filing a grievance will not adversely affect the services you receive. 
*This email is not continuously monitored and is not intended for crisis or emergency services. 
You may also download a copy of our grievance form below and mail or fax it to: 

ACTS Quality Improvement
4612 N. 56th St. 
Tampa, FL 33610
Phone: (813) 246-4899
​Fax: (813) 367-0186