Client Refusal

Easy Does It Emergency Services (EDI) is committed to mutual respect between clients, staff, and the community. However, we know that people don’t always work well together. Clients may request to not work with a particular EDI staff person, and EDI staff may request to not work with a particular client. EDI Management may decide that certain clients and staff cannot work together.

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Client Refusal

Please complete this form to the best of your ability. Although you are more than welcome to remain anonymous providing your information makes it easier for us to identify what went wrong and allows us to follow up regarding actions taken.

Page 1

Contact Details

First Name

Last Name

E-mail Address

Phone Number

Refusal Details

I am an Easy Does It

ClientTeam MemberTeam LeaderOther

Other, Please State your Relationship with EDI

Please tell us who you refuse to work with at Easy Does It.

Their First Name

Their Last Name

Page 2

Refusal Specifics

Tell us why you want a "Refusal". We encourage you to be as specific as possible. Provide details like date, time, location and any "witnesses" to a particular situation. But your request will still be honored if you provide no reason or supplemental documentation. All these fields are optional.

Why do you want to do a Refusal?

Who have you spoken with about this?

What was the outcome?

Please provide any supporting documentation that can help us better understand the situation.