Submit a Formal Complaint

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Before you submit a formal complaint, you should be aware that:
• The College of Dental Surgeons of Alberta (CDSA) only regulates the profession of dentists. If your concern or complaint is regarding a staff member who is not a dentist, please contact their appropriate College.
• You are required to provide your contact information when submitting a formal complaint.
• Formal complaints can be signed and submitted by standard mail or email at pcd@cdsab.ca. For contact information, please see the Professional Conduct Department (PCD) Contact Page.
• Your identity will be made known to the dentist named in your complaint.
• You will be required to engage in the investigation process, which may include being available for an interview during the investigation.
• Once a formal complaint is submitted, the Professional Conduct Department will contact you within seven (7) business days.
• The length of time it takes to conclude a formal complaint varies depending on the complexity.
• Formal complaints are often resolved through communication between the patient and dentist or with the assistance of the PCD.
• At the conclusion of the investigative process, the Complaints Director can send the matter to a hearing, dismiss the complaint, or engage in further resolution efforts. All actions taken by the Complaints Director are governed by Alberta's Health Professions Act.

A reminder that the College DOES NOT:
• Provide diagnosis, referrals, treatment recommendations, or make dentists perform a treatment
• Provide refunds or award damages
• Initiate an investigation without first informing the dentist
• Conduct investigations about dentists from outside Alberta

Your Information

Name*
First Last

Phone*

Email
Enter Email Confirm Email

Address
Street Address Address Line 2 City Province Postal Code Country

Your relation to this formal complaint

If you selected "other" please describe your relation to this concern

Patient Information

Patient date of birth
If you are the patient involved in the complaint, fill in your date of birth and proceed. If you are submitting on half on another person, fill in the birth day followed by the details of that individual.
Month
Day
Year

Patient Name
First Last

Patient Phone

Patient Email

Patient Address
Street Address Address Line 2 City Province Postal Code Country

Your Relationship to the Patient

Add Another Patient
Yes

Add Patient

Patient date of birth
Month
Day
Year

Patient Name
First Last

Patient Phone

Patient Email

Patient Address
Street Address Address Line 2 City Province Postal Code Country

Your Relationship to the Patient

Dentist Information

Dentist Name*
First Last

Dental Clinic Name

Dental Clinic Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

_{If you consulted with or received care from any other dentist in relation to this concern, it may be helpful for us to know that information. We may obtain records from the other dentist. If you list the names of additional dentists, this does not mean you are filing a complaint about them.}

Were other dentists involved in your care?

Yes

No

Add Provider

Name
First Last

Dental Clinic Name

Dental Clinic Address
Street Address Address Line 2 City Province Postal Code Country

Describe Healthcare Providers Relation to Complaint

Add another healthcare provider
Yes

Add Dentist

Name
First Last

Dental Clinic Name

Dental Clinic Address
Street Address Address Line 2 City Province Postal Code Country

Describe Healthcare Providers Relation to Complaint

Information About Your Complaint
If you are the patient, we will obtain your personal health information for the purpose of investigating your complaint. If you are submitting a formal complaint on behalf of a patient, we may ask them to provide applicable consent regarding your involvement.

Describe your complaint in detail

Please upload any supporting evidence (receipts, records, correspondence) that is relevant to your complaint

Drop files here or

Max. file size: 256 MB.

Supported files: .doc, .docx, .pdf, .jpg, .txt

Signature*

Comments
This field is for validation purposes and should be left unchanged.