Complaint Form

REGULATORY COMPLAINT FORM – FOR MEMBERS OF THE PUBLIC

CHCPBC investigates and resolves complaints from members of the public about the capacity, competence, and conduct of the licensed health and care professionals the College regulates.

Check the CHCPBC Public Registry to confirm the person you have a complaint about is a CHCPBC licensee. If the person is licensed by the College, you may use this form to submit a complaint. If your complaint is about someone who is not a licensed health and care professional, please email complaints@chcpbc.org.

CHCPBC will not receive any information until you have filled in all mandatory fields below and clicked the “Submit” button. If you have a large amount of information that does not fit within this form, please email complaints@chcpbc.org.

You must provide your name and contact information when submitting your complaint. CHCPBC will not share your personal contact information (i.e., personal email address, phone number, and home address) with the licensee. For more information regarding CHCPBC’s collection, use, and disclosure of personal information, please see our Privacy Notice.

While complaints cannot be made anonymously, you may apply for an Identity Protection Order, which may keep your name and/or details about you confidential from the licensee you are complaining about, and/or other parties. For more information about Identity Protection Orders and how to apply for one, please see Things To Know Before You Submit A Regulatory Complaint.

If you have any questions about filling out the form and submitting a complaint, or need any assistance to do so, please email complaints@chcpbc.org or call CHCPBC at 604-742-6715.

If you are submitting a regulatory report concerning a licensed health and care professional under the Duties to Report Licensees division of the Health Professions and Occupations Act, please complete the Regulatory Report Form – For Licensees (PDF). For information about when regulatory reports are required, please see Submit a Regulatory Complaint or Report.

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Your Information

Title (e.g. Mr., Ms., Mx., Dr.)

Pronouns (e.g. she/her, he/him, they/them – this information helps us understand how to address people)

First Name*

Last Name*

Any Other Name That You Go By

Are you submitting this complaint on behalf of someone else?

Yes

Patient/Client Title (e.g. Mr., Ms., Mx., Dr.)

Patient/Client Full Name

Your Relationship to the Patient/Client

Patient/Client Preferred Pronouns (e.g. she/her, he/him, they/them – this information helps us understand how to address people)

Does the Patient/Client consent to filing this complaint?

Yes

Address*

Street Address City Province/State ZIP / Postal Code Country

Phone*

Email*

There is a 4,000 character limit in each section below. To provide additional information, you may upload files (totalling up to 5 MB each) by using the File Upload button at the bottom of this form or email them to: complaints@chcpbc.org.

Complaint Details*

To the best of your ability, tell us what happened, including when and where it took place.

Witness/Other Information

If anyone witnessed or has additional information about these events, please provide their name, contact information (if available), and role in the events.

Evidence

If you have any physical or electronic evidence regarding your complaint, please describe it here, upload what you can (using the File Upload button below), and save the remaining evidence for collection.

WHO YOU ARE SUBMITTING A COMPLAINT ABOUT

This form enables you to submit a complaint about a health professional regulated by CHCPBC. To verify the licence of a current CHCPBC licensee, see the Public Registry.

Full Name*

Professional*

Registration Number

Business Contact Information

Confidentiality By submitting this form, I acknowledge that if I wish to keep my identity confidential from the CHCPBC licensee I am complaining about, or others involved in this matter:

I must apply for an Identity Protection Order within the next 10 business days;
My application may or may not be approved;
If approved, the Order may protect my identity from all or only some of the people involved in this matter; and
If denied, I may withdraw my complaint.

Identity Protection If you intend to apply for an Identity Protection Order, please email CHCPBC at complaints@chcpbc.org.

File Upload

Accepted file types: pdf, Max. file size: 5 MB.

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