Complaint Form for Public

This form is for use by members of the public/patients to report complaints regarding regulated members of the Alberta College of Paramedics.

Regulated members who are self-reporting, please use the self-reporting form.
Employers, please use the employer complaint form.

First Steps

Do you have the name of the regulated member about whom you wish to submit a complaint?

To submit a complaint, you must tell us whom it is regarding. To find the name of a regulated member, the Patient Care Record (PCR) will contain the name of the member and details of the care provided. You may request the PCR from the Records Clerk at 403-955-9652.

Once you have their name, proceed with filling out the form below and submitting your complaint. You can include the PCR as part of your complaint.

If you have complaints about more than one member, submit one complaint form per member.
Complete the form(s) with as much detail as possible.

Note

As a regulatory college, there are some things we are not able to do, including:

Negotiate, offer or provide financial compensation; or offer legal advice
Help with concerns about a healthcare provider that is not a regulated emergency medical responder, primary care paramedic or advanced care paramedic in the province of Alberta
Resolve complaints without contacting the regulated member
Accept anonymous complaints (note: the College may request a copy of government issued photo ID to verify your identity)

Next steps

When you submit your complaint, a copy will be emailed to you for your records and is your confirmation that it has been submitted to the College. (Keep for your records.)
When your complaint reaches the Complaints & Conduct department, the Complaints Director will review the information.
The Complaints & Conduct department will correspond with you via email and we contact you and/or the parties you have identified for additional information.
The College will send a copy of your complaint, with your name, to the regulated member(s) for their response. (Your personal contact information will NOT be shared.)
We may contact any individuals or organizations that have been named in your complaint if we believe they can provide additional details. These parties may also receive a copy of your complaint.
Upon the completion of these steps, we will follow up with you.

Notes:

The complaints process can take several months, depending on the complexity and severity of your complaint.
To ensure your complaint form has been submitted, please click the submit button at the bottom of the page.

Email Communication

The College communicates primarily by email, unless the legislation requires us to send you hard copies. Email allows us to process your complaint faster, but if you are unable to communicate by email, please contact us.

Questions?

If you have any issues completing this form, or would like to speak with someone about your complaint before you file this form, please contact the College for assistance:
Tel: 780.449.3114 | Toll Free: 1.877.351.2267

"*" indicates required fields

YOUR INFORMATION

Name (Prefix, First & Last)*

Prefix First Last

Address*

Street Address Address Line 2 City Province Postal Code

Phone (Preferred)*

Email*

Confirm Email*

In this complaint, I am reporting as the/a/an:*

Patient involved

Family member of the patient involved

Friend of the patient involved

Regulated member of the Alberta College of Paramedics

Other healthcare provider (nurse, doctor, etc.)

Other

If you selected "Other," please specify:

If you are filing this complaint on behalf of someone else, you may need to submit proof of your authority (e.g. patient’s signature, will, guardianship order, etc.). If this is required, the College will let you know.

COMPLAINT DETAILS

Date of Incident*

Multiple Incident Dates?

This incident occurred on multiple dates.

2nd Incident Date (Optional)

3rd Incident Date (Optional)

Location of Incident (e.g., home, ambulance, hospital, etc.)*

Name of the patient involved (First & Last)*

First Last

Name of the regulated member involved (First & Last)*

First Last

What (if any) measures have you already taken to resolve your concerns (e.g. spoken with the regulated member, reported to the employer)?*

Please tell us what you believe the regulated member did, or did not do, that lead to your complaint (include as much detail as possible; e.g., the circumstances of what occurred, what resulted, etc.):*

What do you hope will happen as a result of your complaint? Note: the College cannot offer or influence financial compensation as a resolution to your complaint or offer legal advice.*

File

Drop files here or

Max. file size: 25 MB.

ACKNOWLEDGEMENT

By signing below, you agree that the details of your complaint will be shared with the regulated member you have referenced in your complaint.

Signature

Privacy is important to us. Your information is collected, used and disclosed only with your consent, unless otherwise authorized or required by legislation. As per our Privacy Policy, we collect and use your personal information to do the regulatory work of the College, which is mandated by the Government of Alberta through Alberta’s Health Professions Act.

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