Online Forms

Complaint/Concern Form

Any and all complaints/concerns from students participating in clerkship rotations under GMHETC must be submitted using this form in order for such complaints/concerns to be reviewed by GMHETC Special Staff Panel. This applies even if the complaint/concern was also submitted via e-mail and/or verbally.
Please type your full name.
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Please make the selection that best describes the nature of your concern, complaint or request:
Note that this form must be filled for each complaint/concern/incident separately





Describe your complaint/concern/request in as much detail as possible:
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Form - A16

The Center for Haitian Studies (CHS) is a duly registered 501c3 organization, tax-exempt health and social service organization founded in 1988 for the purpose of serving the disenfranchised populations of Little Haiti/Little River in Miami, Florida.

Tel: +1(305) 757 9555

Fax: +1(305) 756 8023

Center For Haitian Studies
8260 NE 2nd Ave
Miami, FL 33138