Common use of Participant’s Signature Clause in Contracts

Participant’s Signature. Date: Administrative Use Only Internal Log # _ Date Received by Staff: Staff Name and Position: Grievance Type: ☐ Grievance ☐ Appeal DocuSign Envelope ID: A82EF366-EF33-46A0-9697-A87AAEE56F93 Attachment B Attachment 3 County of Orange County Executive Office, Office of Care Coordination Shelter Grievance Process The Shelter Grievance Process document is intended to provide Shelter Participants information on their grievance rights and an overview of the process. The County of Orange (County) appreciates feedback and takes grievances seriously. The County will work to resolve Participant grievances in a transparent and efficient manner. If you as a Shelter Participant are unsure of how to access the shelter grievance process within the shelter you are staying, you can reference the information provided during the intake process, ask a shelter staff member, or review grievance information posted in the common areas of the shelter. If at any time during the process you experience difficulty with the shelter grievance process, please reference the Contact Information in Step 3 (below) to contact the County directly via telephone, email and/or mail.

Participant’s Signature. Date: Administrative Use Only Internal Log # _ Date Received by Staff: Staff Name and Position: Grievance Type: ☐ Grievance ☐ Appeal DocuSign Envelope ID: A82EF3662D341B26-EF33E4B7-46A0-9697-A87AAEE56F93 Attachment B 405D-98DE-23D63731F0BE Attachment 3 County of Orange County Executive Office, Office of Care Coordination Shelter Grievance Process The Shelter Grievance Process document is intended to provide Shelter Participants information on their grievance rights and an overview of the process. The County of Orange (County) appreciates feedback and takes grievances seriously. The County will work to resolve Participant grievances in a transparent and efficient manner. If you as a Shelter Participant are unsure of how to access the shelter grievance process within the shelter you are staying, you can reference the information provided during the intake process, ask a shelter staff member, or review grievance information posted in the common areas of the shelter. If at any time during the process you experience difficulty with the shelter grievance process, please reference the Contact Information in Step 3 (below) to contact the County directly via telephone, email and/or mail.

Participant’s Signature. Date: Administrative Use Only Internal Log # _ Date Received by Staff: Staff Name and Position: Grievance Type: ☐ Grievance ☐ Appeal DocuSign Envelope ID: A82EF3663F831037-EF332C85-46A0-9697-A87AAEE56F93 Attachment B 4AED-88BD-91D15A30D243 Attachment 3 County of Orange County Executive Office, Office of Care Coordination Shelter Grievance Process The Shelter Grievance Process document is intended to provide Shelter Participants information on their grievance rights and an overview of the process. The County of Orange (County) appreciates feedback and takes grievances seriously. The County will work to resolve Participant grievances in a transparent and efficient manner. If you as a Shelter Participant are unsure of how to access the shelter grievance process within the shelter you are staying, you can reference the information provided during the intake process, ask a shelter staff member, or review grievance information posted in the common areas of the shelter. If at any time during the process you experience difficulty with the shelter grievance process, please reference the Contact Information in Step 3 (below) to contact the County directly via telephone, email and/or mail.

Participant’s Signature. Date: Administrative Use Only Internal Log # _ Date Received by Staff: Staff Name and Position: Grievance Type: ☐ Grievance ☐ Appeal DocuSign Envelope ID: A82EF3665A9520EF-EF33A015-46A04FE1-969781A2-A87AAEE56F93 Attachment B 179AD1378E92 Attachment 3 County of Orange County Executive Office, Office of Care Coordination Shelter Grievance Process The Shelter Grievance Process document is intended to provide Shelter Participants information on their grievance rights and an overview of the process. The County of Orange (County) appreciates feedback and takes grievances seriously. The County will work to resolve Participant grievances in a transparent and efficient manner. If you as a Shelter Participant are unsure of how to access the shelter grievance process within the shelter you are staying, you can reference the information provided during the intake process, ask a shelter staff member, or review grievance information posted in the common areas of the shelter. If at any time during the process you experience difficulty with the shelter grievance process, please reference the Contact Information in Step 3 (below) to contact the County directly via telephone, email and/or mail.

Participant’s Signature. Date: Administrative Use Only Internal Log # _ Date Received by Staff: Staff Name and Position: Grievance Type: ☐ Grievance ☐ Appeal DocuSign Envelope ID: A82EF36634D2C0D8-EF3317A6-46A0-9697-A87AAEE56F93 Attachment B 4D6E-922C-77E8D580EEC8 #:4256 Attachment 3 County of Orange County Executive OfficeHealth Care Agency, Office of Care Coordination Shelter Grievance Process The Shelter Grievance Process document is intended to provide Shelter Participants information on their grievance rights and an overview of the process. The County of Orange (County) appreciates feedback and takes grievances seriously. The County will work to resolve Participant grievances in a transparent and efficient manner. If you as a Shelter Participant are unsure of how to access the shelter grievance process within the shelter you are staying, you can reference the information provided during the intake process, ask a shelter staff member, or review grievance information posted in the common areas of the shelter. If at any time during the process you experience difficulty with the shelter grievance process, please reference the Contact Information in Step 3 (below) to contact the County directly via telephone, email and/or mail.