Every student of Hillcrest has the right to voice their concerns / complaints, without fear of reprisal. There are several people on the campus who can help you with this. If you have concerns that your rights have been violated, you were mistreated or you did not receive adequate treatment services, you may file a grievance. Your concerns must be written and submitted to your clinician. Your clinician will review the grievance and within 24 hours, will notify the appropriate individuals, who will then conduct the investigation of the allegation. These individuals may include, but are not limited to, Supervisors, Program Managers, Program Directors and the Human Rights Representative on your campus. Upon receipt of the grievance, the Human Rights representative will only be involved if it appears that the grievance involves a violation of your rights. The primary role of the individual is not of an advocate, but as an advisor to the investigative committee. You are free, at any time, to notify your agency, lawyer or guardian of your concerns.

 

The Human Rights representative for this campus is (print name)

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The Human Rights alternate representative for this campus is (print name)

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As a student at Hillcrest Educational Centers I understand and have received a copy of Hillcrest’s Statement of Human Rights.

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Student signature                                                                                 Date

This section should be completed only if the student may not be capable of
understanding their rights and/or the complaint/grievance procedure.

Parent, guardian or representative of the student: I understand and have received a copy of Hillcrest’s Statement of Human Rights.

Student’s name _____________________________________________________________________

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Parent/Guardian/Representative signature                         Date

Relationship to student (please print):

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Witness – print name                                                                          Date

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Witness – signature