Get Tx Tbce Complaint Form

The TX TBCE Complaint Form is an essential document for individuals seeking to register a complaint against a chiropractic practitioner or facility. This guide will provide you with a clear, step-by-step process for filling out the form online, ensuring that you complete all necessary fields accurately and effectively.

Follow the steps to fill out the TX TBCE Complaint Form online

1. Press the 'Get Form' button to access the TX TBCE Complaint Form and open it in your editor.
2. In the section labeled 'Complaint Registered Against,' provide the name of the practitioner or facility, their address, city, state, and zip code, along with their business phone number.
3. For the 'Person Registering Complaint' section, enter your name and contact information, including your address, city, state, home phone number, business phone number, zip code, and email address.
4. In the 'Patient/Person Harmed by the Practitioner' section, fill in the name and date of birth of the affected person.
5. Locate the 'Location Where Complaint or Violation Occurred' section, and provide the relevant address, city, county, state, and zip code.
6. In the 'Details of Complaint' area, describe your complaint thoroughly, including specific incidents, relevant dates, and locations of any treatment involved. Note that additional documentation may be attached if necessary.
7. Answer the question regarding whether you have obtained a second opinion from another healthcare provider; if yes, provide the practitioner's name, address, city, state, and zip code.
8. After completing the form, confirm all the provided information is accurate. You will need to sign and date the form, affirming the truthfulness of your statements.
9. Finally, save your changes, and you may choose to download, print, or share the form as needed. Ensure that the completed form is submitted via email, fax, or mail as specified.

Take action today and complete your TX TBCE Complaint Form online to ensure your concerns are addressed.