Should you have a grievance; please use the electronic form and the appropriate staff member will contact you in a timely manner.
Electronic Grievance Form – On-line Filing
Complete and submit on-line. Grievances Form
Printable Grievance Form – Fax or Mail
You also have the option to print out a hard copy to mail or fax to us.
Printable Grievance Form – English
Printable Grievance Form – Spanish
Upland Corporate Office
1202 Monte Vista Avenue, Suite 17
Upland, CA 91786
Fax # (866) 698-7773