Mail-in Complaint Form - Contact Information □ □

Pronouns □ I do not have pronouns, please refer to me by my name □ Prefer not to disclose (If you choose not to disclose, we will use your full name in all correspondence) Email Email communications with the BC Ombudsperson are subject to our email policy posted on our website www.bcombudsperson.ca. [...] However, we may need to com- municate with you by other methods in order to get the information we need to assist with your complaint. [...] □ No □ Yes, as First Nations □ Yes, as Métis □ Yes, as Inuk (Inuit) □ Yes, as Indigenous □ Prefer to self-describe: What else do we need to know about contacting you? This might include: ● international phone numbers or a number where we can leave a voice mail ● requests for interpreter or relay services or other accommodations ● you have a representative (such as an advocate, Elder or support per. [...] BC OMBUDSPERSON 3 MAIL-IN COMPLAINT FORM Who have you dealt with/spoken to about your complaint? Please include, if possible, names, titles and contact information for the main people you have dealt with at the organization(s), and the dates you have been in contact with them. [...] What steps have you taken to try to resolve your complaint? Have you filed an appeal? Tell us about any complaint, appeal, review or reconsideration process you have used, or other steps you have taken.