Submit a Complaint

How to submit a complaint

There are only three things we need to begin the process:

Your name and contact information. If you are complaining on behalf of someone else, the name of that person or the person making the complaint (either you or someone you are acting for).
The name of the health professional you are complaining about
Details of your complaint

Complaint form

1. About You

Salutation (e.g. Mr., Mrs., Ms., Mx., Dr.)

Full Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

An email confirmation will be sent to this address.

Phone *

Mobile

Date of Birth (Optional)

Are you making this complaint on behalf of someone else?

No
Yes: I am acting on behalf of a child under 15 who is in my care
Yes: I am acting on behalf of someone else

2. Who is your complaint about?

Full name of the oral health profession (registrant) you are complaining about:

First and Last Name of Registrant *

First

Last

If you are making a complaint about more than one registrant, please complete a separate complaint form for each.

3. Details of your complaint

Please tell us about your experience and the events that led you to file this complaint. You can use the box below or include a separate attachment. It will be helpful to our investigators if you are able to provide as many details as possible, including:

dates of treatment and/or interactions with the registrant
whether you have attempted to resolve this issue with the registrant, and if so, what the results were
any relevant documents/records
description of your ideal resolution (outcome) of this complaint

Complaint *

Supporting Documents

Click or drag files to this area to upload. You can upload up to 6 files.

If you have more than 6 supporting documents, you can upload a zip file containing all of your supporting documents.

Other oral health care providers

Please list the name(s) of any other BCCOHP registrants who were involved in the events that led to your complaint or who have knowledge of your oral health care status.

I agree that as part of the investigation of my complaint:

BCCOHP will provide a copy of my complaint to the health professional who is the subject of my complaint so that they can respond to it
BCCOHP may ask other registrants involved in this matter to provide them with relevant reports and/or patient records

Signature *

Date *