Policy and Forms

Policy and Forms

Please fill this form out in it's entirety. We will never ask for your identity.

Printable Grievance Form



It is the policy of SunServe to receive and resolve client concerns and grievances in a timely manner. 

It is noted that there will be no retaliation or barriers to services should a client file a grievance or a complaint. 


Concern:  An expression of dissatisfaction.  Concerns are the least serious form of discontent covered by this policy.

Grievance:  A charge of unfair treatment, illegal, unprofessional or unethical behavior on the part of the staff, the program and/or the grant requirements.  This is a more serious charge that, despite all parties’ best intended efforts, has not been resolved and, therefore, necessitates formal proceedings.  This includes grievances and or complaints of discrimination. 


All clients receive a copy of their Rights and Responsibilities and are made aware of the grievance procedure. This is received in a variety of settings and throughout our programs. The document is signed and witnessed, and a copy is placed in the client file.

All clients are encouraged to seek problem resolution as soon as possible after a concern is realized or a conflict occurs. Client concern and suggestion forms are available at all locations.

Should a client have an issue with a specific individual (client or staff member), they are strongly encouraged to directly address the concern with the individual.

The initial contact for concerns is the client’s direct service provider. In the event the client is not satisfied with the outcome, the client is referred to the supervising Program Director.

If the client is not satisfied with the Program Director’s response, a grievance form can then be completed and forwarded to the Human Resources Director for intervention. The Human Resources Director will review grievance, make inquiries with all identified parties and address the grievance within 15 business days providing a written response.

Grievance forms and procedures are readily accessible at each location of each service facility.  Clients and other stakeholders may access the forms without requesting from a staff member. 

If the client is not satisfied with response of the Human Resources Director, the issue will be forwarded to the Executive Director, who will review grievance as well as Human Resources’s findings, make additional inquiries if appropriate to all involved parties and then respond to the client within 5 business days.

If either party determines a conflict is still evident, additional consultation may be sought through the appropriate grantor’s office or licensing office stemming from the client’s programmatic affiliation. The Human Resources Director will facilitate the process with the support of the Executive Director. 

Identification of the Ryan White Part A Program Office as the final recourse should efforts to resolve the grievance not be successful.  This shall include the phone number for the Ryan White Part A Program (954) 537-5390.  This only applies to grievances involving the programs funded by the Ryan White Part A program (Ryan White Mental Health).

SunServe’s internal grievance form will be copied twice to be distributed so the client may keep a copy of the form, and if required, a copy can be sent to the appropriate grantee or licensing entity for final resolution. 

If you feel that you were discriminated against, please explain how, why and when you believe you were discriminated against and include, in detail, the alleged acts of discrimination. Note the basis of discrimination: Race, Color, National Origin, Sex, Age, Handicap/disability, income status, retaliation or other.

Alternate means of filing complaint, such as personal interviews or a tape recording of the complaint, will be made available for persons with disabilities, upon request.

Rev. 6.4.2018