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ETHICS COMPLAINT FORM
PDF
Online versions are preferred however if you require a pdf form please contact the Ethics Administration office at
ethicsadministrator@athletictherapy.org
All fields with "*" are required in order to submit a CATA complaint.
Complaint Filed Against
Incident Date *
Submission Date
Athletic Therapist Name *
Employer
Phone Number *
Email Address
Location of Incident *
Address *
City *
Province *
BC
AB
SK
MB
ON
QC
NB
NS
PEI
NL
YT
NWT
NU
Postal Code *
Complaint Filed By
Name *
Relationship to Therapist
Phone Number *
Email Address *
Address *
City *
Province *
BC
AB
SK
MB
ON
QC
NB
NS
PEI
NL
YT
NWT
NU
Postal Code *
Complaint Summary *
Complaint Witnesses
Identify the section(s) of the CATA Code of Ethics and Professional Conduct that you feel is alleged to have been violated. *
For the CATA Code of Ethics and Professional Conduct document click
here
.
Please upload any documentation supporting your assertion of said violation(s).
Please upload PDF file(s):
Electronic Signture:
