Formal Complaint Form

Use this form to file a formal complaint regarding one of our employees or the Galiano Health Care Society as a whole.

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You can download a printer friendly version of this form if you prefer to file your complaint in writing

Matters outside our jurisdiction:

Please note that we can only consider complaints about the Galiano Health Care Society and its employees. BC Health Care Professionals (i.e. doctors, nurses) are funded by the Vancouver Island Health Authority (IH) and are regulated by their College or Regulatory body and are not our employees.

Where there are regulated health care professionals who are our employees (e.g. social worker), we will direct you as to the correct place to send your complaint. Below are the links for complaints we are not able to take (i.e. because they are a member of a regulated profession); if uncertain, feel free to contact us about your complaint and where it would be appropriate to direct it.

For a complaint regarding a physician, visit the College of Physicians and Surgeons website.

For a Dentist, visit the College of Dental Surgeons of British Columbia website.

For a Registered Nurse, visit the College of BC Nurses website.

For a Registered Social Worker, visit The BC College of Social Workers website.

If your complaint is regarding an emergency services employee (paramedics); please email the BC Emergency Medical Service.

If a complaint is about other regulated Health care providers, their regulators can be found at the BC Health Regulators website.

For complaints related to chronic shortages of funding for health issues for our island which are outside of GHCS’s control (e.g. shortage of healthcare providers and resulting waiting lists for primary care services) we support advocacy with Vancouver Island Health Authority and/or the BC Ministry of Health. We also appreciate you bringing these complaints to our attention for the betterment of health services in our community.

Please note we will not investigate complaints that are over a year old except in extenuating circumstances.

Please see our Complaints Investigation Policy for the process of complaint investigation

Complaints Investigation Policy

Full Name

Address

Phone Number

Email Address

Are you the complainant? Are you the complainant? I am the complainant I am representing the complainant for the purposes of this complaint.

Full Name of Complainant

Address of Complainant

Phone Number of Complainant

Email Address of Complainant

How Would You Like to be Contacted? How Would You Like to be Contacted? By Phone By Email

Is this complaint against the GHCS as a Society? Is this complaint against the GHCS as a Society? Yes No

Who is the complaint against (the "Respondent")? Please note all Respondents will be notified of the Complaint as per the GHCS Complaint Process Policy.

Please describe the nature of your concern Provide the full particulars of the issue or incident that gives rise to the complaint (include date, time, location, and what occurred)

If there was a specific incident, were there any witnesses to the Event? If so, please provide their names and contact information, if known, or indicate this information will be provided at a later date.

Is there a specific remedy or action you are seeking from the GHCS? If so, please set that out as specifically as possible.

Are there any relevant documents that your would like to attach now? You may upload up to 3 documentsFile InputNo Files ChosenAccepted file types: txt, asc, c, cc, h, srt, pdf, docx. Max. file size: 5 MB

Document will be forwarded at a later date? Document will be forwarded at a later date? Yes No

Complainant Signature All complaints must be signed by the complainant and/or complainant’s representative. You can sign your name using your mouse on desktop computers, your touchpad on your laptop, or your finger on your phone or tablet.Save Clear

Representative Signature All complaints must be signed by the complainant and/or complainant’s representative.Save Clear

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