KDH receives complaints from patients or caregivers of patients. Receiving complaints in writing ensures that there is no risk of miscommunication or misinterpretation.

If you have any difficulty with this form, please contact Patient Relations by email at patientrelations@kdh.on.ca, or at 613-258-6133, ext. #268.



    Date of birth *






    Patient's date of birth *



    People involved in this complaint (check all that apply):

    Date of event:



    Department involved (check all that apply):