*I claim direct, first-person knowledge related to this grievance:
*Grievant relationship to provider:
Other:
*Provider Name (Facility against whom Grievance is being filed):
Provider Street Address:
Provider City:
Provider State:
Postal Code:
Primary Contact:
Provider Phone:
Grievant alleges provider non-compliance with NARR Core Principles listed below. (please select all that apply):
Residence is a home Residence is peer staffed and governed Residence is recovery-oriented Residence Operates with integrity Residence promotes health Residence upholds resident rights Other (Please Describe)
Other:
*Nature of Grievance (Please provide a detailoed narrative explaining the nature of the grievance below):
Supporting Documentation:
*I certify that the above information is entirely accurate to the best of my knowledge.:
Certifying Recovery Residences to the NARR Standard and promoting effective delivery of recovery support services within community-based, residential setting is our primary mission.
