Complaint form: complain about a member

Your name*
First Last
Your phone number*
Your email address*
Enter Email Confirm Email
Your address
Street Address Address Line 2 City ZIP / Postal Code
Member's name*
First Last
Firm
Member's email address
We will contact the member to inform them you have raised concerns. Please let us know if there are any reasons why you would prefer we didn't.
Is your complaint about a mediator?*
- Yes
- No
Name of the other person involved in the mediation
First Last

What happened?
Please tell us what happened and which areas of the Resolution Code of Practice (or the Family Mediation Code of Practice if your complaint is about a mediator) have been breached. Try to include any details that will help us understand what happened and any significant dates. If your complaint isn't about a breach of the Code of Practice we will try to help you make a complaint elsewhere.
Please provide up to five documents that directly support your complaint. Only submit documents which directly relate to your complaint. Please do not send us any court documents.
Drop files here or
Please describe how the events affected you so our member can understand the impact it has had.
What would you like to happen as a result of your complaint? The actions we can take are in our complaints policy, we can't get your money back or stop someone practicing.
By checking this box you confirm we can share the information and documents you've given us with our complaints team, the member so they can respond, and the Practice Standards Panel so they can consider your complaint. Everyone will treat your information as confidential and we won't share your information with anyone else without your consent.*
I confirm
By checking this box you confirm we can share your form and any other documents with our complaints team and the member so they can respond. You also confirm that, if necessary, we can share this information with our Independent Practice Standards Panel. Everyone involved will treat the information you provide as confidential. We won't share information with others without your consent.

Complaint form: complain about a member

Complain about a member

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