Submit a Complaint: The Alberta College of Dental Hygienists

Email:

Mail:

ATTN: Complaints Director

302, 8657 - 51 Avenue

Edmonton AB T6E 6A8

Note: As per Part 4 - Professional Conduct - in the Health Professions Act (HPA), a complaint must be signed and submitted in writing.

Complaint Reporting Form

First name *

Last name *

Email *

Phone number *

Address *

City *

Province *

Postal code *

Dental Hygienist name *

Dental Hygienist Registration Number

Clinic name *

Clinic phone number *

Clinic address *

Clinic city *

Complaint *

Submit all relevant details of your complaint here.

Supporting documentation

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Today's Date *

Signature *

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