Get Complaint Form - College Of Physicians And Surgeons Of Ontario

Filing a complaint with the College Of Physicians And Surgeons Of Ontario can be an essential step in addressing concerns regarding physician conduct or care. This guide provides a clear, step-by-step process for filling out the Complaint Form online, ensuring that users can submit their complaints effectively and confidently.

Follow the steps to complete the Complaint Form online

1. Click the ‘Get Form’ button to obtain the form and open it in the designated editor.
2. In Section A, enter your personal information. Provide your last name, first name, apartment number (if applicable), street address, city, province, postal code, daytime telephone number, alternate telephone number (if any), and email address. If you are not the patient, describe your relationship to the patient.
3. In Section B, input the patient’s details. If the patient’s information is the same as the complainant’s, select the option provided. Fill in the patient's first and last names, apartment number, street address, city, province, postal code, daytime telephone number, alternate telephone number, email address, date of birth, and date of death if applicable. Ensure that the patient signs the online consent form if they are not the complainant.
4. Proceed to Section C to provide details about the physician you are complaining about. Enter the first name, last name, suite number (if applicable), street address, city, province, specialty, daytime telephone number, and specify where you saw this physician (e.g., office, hospital). Include the dates of any treatments received.
5. In Section D, identify any other physicians who provided medical care relevant to your complaint. For each physician, enter their first name, last name, suite number, street address, city, province, postal code, specialty, and telephone number. Specify where you saw each physician and the treatment dates.
6. Complete Section E by listing the names and dates attended for any hospitals or care facilities relevant to your complaint. If you have information on more than two facilities, continue on a separate sheet.
7. In Section F, outline the details of your complaint on a separate sheet. Summarize your areas of concern (e.g., care, behavior) and provide a detailed description of why you are concerned. Include any efforts made to resolve the issue.
8. If you are the complainant and also the patient, review Section G for acknowledgment and signature. Make sure to read and understand the information regarding confidentiality and medical information sharing. Date the section and add your signature.
9. After completing the form, print it out, sign it, and mail it to the Registrar at the College’s address provided at the bottom of the form. Ensure no part of the process is completed via email due to the need for an original signature.

Take the first step in voicing your concerns by completing the Complaint Form online today.