AMERICAN RED CROSS Nurse Aid Testing
CANDIDATE GRIEVANCE FORM Please complete this form completely and mail to: American Red Cross, 1804 S Sixth Street, Harrisburg, PA, 17110. This grievance letter must be received, completely filled out, by the American Red Cross within 30 days following your exam. Your complaint will be reviewed and you will be notified in writing of the findings within 30 days. Today’s date:_______________________ Name & address of individual completing form: _________________________________ _________________________________ _________________________________ _________________________________ Home phone ( )___________________ Daytime phone: ( )_________________ Name & address of test site: ______________________________ ______________________________ ______________________________ ______________________________ Date tested:____________________
Please state your grievance; you may use the other side of this paper if necessary.