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C. The parent, organization, or individual filing the complaint must submit a signed written complaint to the Part C Coordinator and simultaneously forward a copy of the complaint to the EI provider serving the child. D. The complaint must be completed, signed, dated and submitted to the Part C Coordinator. The Early Intervention Complaint form is given to parents at Intake and is available on line at: http://www.eohhs.ri.gov E. The EI provider will assist the parent in filing a written complaint if requested. F. The Early Intervention Complaint Form (or facsimile) shall be used and must include: 1. A statement that the EI provider has violated a requirement of Part C of the IDEA; 2. The facts on which the statement is based; 3. The signature and contact information for the individual filing the complaint; and 4. The name and address of the child; 5. The name of the EI provider serving the child; 6. A description of the nature of the problem of the child, including facts relating to the problem; and 7. A proposed resolution of the problem to the extent known and available to the party at the time the complaint is filed. G. The violation must have allegedly occurred not more than one (1) year prior to the date that the complaint is received. H. The lead agency will conduct an investigation of the complaint through interviews and a review of the early intervention record(s) or may determine that an independent on-site investigation is necessary. The complainant will be given the opportunity to submit additional information orally or in writing within the required timeline. I. The EI provider will be given an opportunity to respond to the complaint; including at the discretion of the lead agency, a proposal to resolve the complaint. J. A parent who has filed a complaint will be given an opportunity to voluntarily engage in mediation with the EI provider.