Grievance Form definition
Examples of Grievance Form in a sentence
The parties agree to use the electronic version of the (O.N.A. Grievance Form at Appendix 1 of the Hospital Central Agreement).
The parties agree to use the electronic version of the ONA Grievance Form at Appendix 1 of the Hospital Central Agreement.
The Subscriber, a designated representative, or a provider on behalf of the Subscriber, may also ini- tiate a grievance by submitting a letter or a com- pleted "Grievance Form".
Member complaints or grievances can be made in person, at any Participating Dentist’s office or by obtaining a Grievance Form from CDN by writing, faxing or calling CDN as follows, or by visiting the website at ▇▇▇.▇▇▇▇▇▇▇▇▇.▇▇▇: Completed Grievance Forms must be mailed to CDN at the address listed above.
If the Member wishes, the MHSA’s Customer Service staff will assist in completing the Grievance Form.