THE ASSOCIATION FOR PROFESSIONAL HYPNOSIS & PSYCHOTHERAPY COMPLAINT FORM

In the first instance of a grievance with one of our members, you must contact the therapist direct and try to resolve the issue, giving them a reasonable amount of time to reply. If you have not done this yet, please do so before contacting the APHP.

If you have contacted the therapist in question and still wish to submit a complaint, please read below and fill in all of the details.

Copies of your signed Therapy Contract and receipt for services must be included with a hard copy of your complaint.

Please fill the form below and after submitting online, please also post a copy of your complaint to:

APHP LTD
The Admirals Offices,
Suite B9,
The Historic Dockyard,
Kent
ME4 4TZ
UK

If all details are not complete, or you do not provide evidence of your identity, we cannot proceed with a complaint.

Name*

Please include your full name including any title

Address*

Email*

example@example.com

Telephone Land-Line Number

Format: (000) 000-0000.

Telephone Mobile Number*

Please enter a valid phone number.Format: (000) 000-0000.

Please upload a form of ID that shows your full name and address details*

Details of APHP Registered Practitioner/Trainer:

Name*

Address*

Email*

example@example.com

Telephone Number*

Format: (000) 000-0000.

Please provide the therapists website or social media links*

Date of alleged Professional Misconduct*

If more than one date please explain this in the details of the incident, below

Details of Incident - please be specific*

If you have any witnesses to the misconduct, please provide their details below, we contact all witnesses for further information. If there were not witnesses, please leave blank.

Witness 1 Full Name

Address

Email

example@example.com

Mobile

Format: (000) 000-0000.

Signature of Witness

Witness 2 Full Name

Address

Email

example@example.com

Mobile

Format: (000) 000-0000.

Signature of Witness

(Signed consent of additional witnesses if any, can be sent separately with your paper copy)

Details of attempt to resolve issue to date or reasons for not doing so*

Details of how this matter can be resolved to your satisfaction*

1. I declare that the information given in relation to my complaint is accurate.

2. I have enclosed copies of all relevant documentation (signed therapy contract, receipts and proof of ID

3. In accordance with GDPR, I consent to information being disclosed to the appropriate parties.

4. I consent to the APHP contacting me by phone and/or email or post.

5. If I am not satisfied with the final response, I confirm that I will abide the Ethics Comittee

Please note, in order for some cases to be thoroughly investigated we may need to disclose your name and the details of when you saw the therapist to the therapist. This is because they may need to check case notes. We may also need to request a copy of your notes.

Signature*

Date*

Date

APHP LTD The Admirals Offices, Suite B9, The Historic Dockyard, ME4 4TZ Registered England No 04135568