RCO Grievance Form

We appreciate you taking the time to share your concerns. This grievance process is designed to address issues related to Recovery Community Organizations (RCOs) currently certified by Faces & Voices of Recovery.

Password(Required)

Please enter your password to proceed. Note when copying and pasting not to include leading or trailing spaces.

Acknowledgement(Required)

This process covers concerns related to ethical practices, guidelines, and conduct as they pertain to:
- The RCO Definition
- RCO National Standards
- Providing a safe and healthy work environment
- Maintaining accurate record-keeping and organizational processes aligned with confidentiality and peer-led principles
- Demonstrating proficiency in non-profit fiscal management and financial stewardship
- Serving as a valuable collaborative partner in the recovery community
Some matters may fall outside our scope and require involvement from other entities or agencies.

I acknowledge and understand the scope of this grievance process.

About You

Are you submitting this grievance:(Required)

On your own behalf

As an authorized representative for someone else (It is required to provide proof of proxy authorization.

Upon completing this grievance submission, a proxy authorization form will be provided to you.

Contact Information

We will need to contact you for additional details or updates. Your information will remain confidential and will not be shared without your consent. Correspondence will occur by email to ensure written documentation of actions and resolution. Valid contact information is required in order to review, process, and resolve this grievance.

Full Name:(Required)

First Last

Best Phone:(Required)

Best Time to Call (and Time Zone):(Required)

Email Address:(Required)

Organization Involved

Name of Organization:(Required)

Is this grievance related to a specific incident?(Required)

Yes

No – this is an ongoing concern

If  yes, please provide the Date of Incident:(Required)

MM slash DD slash YYYY

Grievance Details

Please select the area(s) your grievance relates to and provide details:(Required)

RCO Definition (Explain how this grievance relates to the RCO Definition.)

RCO National Standards (Reference specific standards if possible.)

Safe and Healthy Work Environment (Provide details explaining how this grievance relates to a safe and healthy work environment.)

Record-Keeping Practices (including confidentiality and peer-led processes) (Provide details explaining how this grievance relates to record-keeping practices, including confidentiality and peer-led processes.)

Financial Stewardship and Non-Profit Fiscal Management (Explain how this grievance relates to financial practices or fiscal responsibility.)

Compliance with Laws and Regulations (Provide details explaining how this grievance relates to compliance with state, local, or federal laws, rules, and/or regulations)

Collaborative Partnership in the Recovery Community (Explain how this grievance relates to the organization’s ability to serve as a valuable collaborative partner.)

Financial Stewardship is the ethical, accountable and responsible administration of resources including money, property, and people for the long-term health of the organization. Fiscal Management is compliance and management money for business operations, including budgeting, financial record-keeping, financial reporting, compliance with laws, and preventing and reporting errors and fraud.

RCO Definition Details(Required)

RCO National Standards Details(Required)

Safe and Healthy Work Environment Details(Required)

Record-Keeping Practices Details(Required)

Financial Stewardship and Non-Profit Fiscal Management Details(Required)

Compliance with Laws and Regulations Details(Required)

Collaborative Partnership in the Recovery Community Details(Required)

Additional Information

Are there any witnesses?(Required)

Yes

(If Yes, please note you may be required to provide contact information, including name, phone number, and email address for the purpose of investigation and resolution.)

Please upload any supporting documentation related to this grievance:

(Accepted formats: PDF, DOCX, JPG.)

Drop files here or

Max. file size: 10 MB.

Have you filed this grievance with another organization or agency?(Required)

Yes

If Yes, please provide details.(Required)

Have you initiated legal proceedings related to this grievance?(Required)

Yes

If Yes, please provide details.(Required)

Confirmation

After submission, you will receive a confirmation email. If you do not see it, please check your spam folder.

Acknowledgement of Grievance Appeals

Acknowledgement(Required)

I understand that if the grievant or organization disagrees with the outcome of a grievance or subsequent revocation of certification, either party may submit a written appeal via email within 30 days of receiving the decision. Appeals will be reviewed by an independent panel designated by FVR.(Required)

Attestations

Please review and check each box:

I attest that the information provided is true and accurate to the best of my knowledge.

I affirm this grievance is submitted in good faith and not for malicious, frivolous, or retaliatory purposes.

I consent to being contacted for additional information.

I understand confidentiality will be maintained to the extent possible, but some information may need to be shared during the review process.

I understand I may be asked to consent to information sharing related to this grievance. This information may be shared with individuals involved in the review or investigation process as necessary.

I acknowledge I have reviewed and understand the grievance procedures.

I authorize the certifying body to review and investigate this grievance.

I understand retaliation for filing a grievance is prohibited and agree to report any concerns promptly.

I understand that grievances outside of the scope of RCO certification are unable to be resolved through this grievance process.

I understand that some instances may include a recommendation or a referral to legal authority, agency, or other entity for legality purposes.

Signature

Name(Required)

First Last

Signature(Required)

Date(Required)

MM slash DD slash YYYY

RCO Grievance Form

About You

Contact Information

Organization Involved

Grievance Details

Additional Information

Confirmation

Acknowledgement of Grievance Appeals

Attestations

Signature

ABOUT US

PROGRAMS

ENGAGE

RESOURCES

CONTACT

RCO Grievance Form

About You

Contact Information

Organization Involved

Grievance Details

Additional Information

Confirmation

Acknowledgement of Grievance Appeals

Attestations

Signature

ABOUT US

PROGRAMS

ENGAGE

RESOURCES

CONTACT

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