Carol Gray Center for CST Studies Craniosacral Therapist Complaint Form

Carol Gray Center for CST Studies Craniosacral Therapist Complaint Form
If you believe a Craniosacral Therapist trained or certified by the Carol Gray Center for CST Studies has violated the Carol Gray Center for CST Studies Code of Ethics and/or Standards of Practice, please complete the form below to the best of your ability.
Your Name*

First NameLast Name
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Phone Number*
Your Email*
example@example.com
Name of the Person About Whom You Are Filing a Complaint*

First NameLast Name
Address of the Person About Whom You Are Filing a Complaint

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number of the Person About Whom You Are Filing a Complaint
Email of the Person About Whom You Are Filing a Complaint
example@example.com
Please give a detailed description of the facts supporting the complaint.*
Please give a description of any steps that have been taken to address the situation in the complaint, and the results of any such steps.*
Please list the specific section(s) of the Code of Ethics and Standards of Practice you believe have been violated.*
The Carol Gray Center for CST Studies Ethics and Standards Committee has my permission to disclose all information in the complaint to the person named in the complaint, the members of the Carol Gray Center for CST Studies Ethics and Standards Committee, the investigative team, staff, legal counsel and experts involved in handling the complaint.*

I agree
Your Signature*

Clear
Please upload any files that provide supporting information.

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