Complaint Form


Instructions

o Complete this form
o Make sure you have:

  • signed the form on page 4
  • signed the consent for release of your information and records on page 5
  • attached copies of any relevant documents
  • Send the completed form by mail or e-mail to:


    • Complaints
    Association of Registered Clinical Hypnotherapists
    6248 Main Street
    Vancouver, British Columbia, V5W 2V1
    e-mail: office@archcanada.ca

    The Association of Registered Clinical Hypnotherapists (ARCH) is a Canada-wide accrediting registry for
    qualified Hypnotherapists and Counselling-Hypnotherapists. ARCH promotes the professional conduct of
    its registered members, consistent with the ARCH Code of Ethics and Standards of Practice. Complaints
    about the ethical or professional practice of a registered member (Member) that are received in writing
    are reviewed by ARCH. Complaints are reviewed in the order they are received. Please be aware that the
    review process is detailed and can be lengthy, depending on the circumstances. The length of time
    required for resolution will also vary.
    Once ARCH has received your complaint, you will be notified by mail or e-mail and provided with contact
    information for the ARCH representative responsible for your file. If at any time you would like an update
    on your complaint, please call the representative with your file number ready.

    Before completing this form, please consider that ARCH is not able to:
  • make, direct or influence the payment of financial compensation to complainants or Members,
  • investigate complaints without offering the Member the opportunity to respond,
  • assist with concerns or complaints about activities or conduct of Members that are not relevantto ARCH’s mandate, including a Member’s compliance with the Code of Ethics or Standards of
    Practice, or
  • assist with concerns or complaints about non-Members

    • Your Contact Information
      
                      
        
        
     
    ARCH Member Details
    Please identify the ARCH Member you are filing this complaint about and include an office address if
    available. Note: a copy of this complaint may be sent to the Member you have identified.
      
                      
        
        
    Have you tried speaking with this Member about your concern(s)?
     
    Relief Sought

    Please describe what you would like to see happen as a result of this Compliant.
    Note: ARCH cannot make, direct or influence the payment of financial compensation to complainants or
    Members.





    Details of Your Complaint

    Please describe your concern in as much detail as possible. Provide details of what occurred between
    you and the ARCH Member including dates and locations. Please enclose copies of any documents that
    you feel would be relevant to your complaint. If you believe there has been a violation of the ARCH
    Code of Ethics or Standards of Practice please provide details.
    Note: a copy of this complaint may be sent to the ARCH Member you have identified





    Confirmation and Consent

    I understand and agree:

  • ARCH may obtain my relevant clinical records and other personal information as part of the
    investigation. I will sign the attached Consent for Release of Confidential Information and
    Records, unless ARCH determines this information is not relevant to my complaint. I understand
    ARCH may refuse to proceed with my complaint if I do not consent to the release of my
    confidential information and records.

  • ARCH will share some or all of the information and documents it receives from me and other
    parties to the member under investigation.

    •
  • The investigation may include participation from the ARCH Board of Directors, relevant ARCH
    Committees or the ARCH legal counsel.

    •
  • The investigation may include further correspondence or interviews with me.

    •
  • ARCH may refuse to consider or dismiss complaint at any stage if it is received more than one (1)
    year after the alleged event(s) or violation(s) which form the substance of the complaint.

    •
  • Where there are criminal or other legal proceedings relevant to the complaint, ARCH may
    suspend investigation or disciplinary processes until the criminal or other legal proceedings have
    been resolved.

    •
  • ARCH may proceed with an investigation and disciplinary process even if I withdraw my
    compliant, choses not to pursue my complaint, or refuse to participate in the process.

    •
  • I may engage legal counsel but will be solely responsible for the costs of my legal counsel.

    •
  • My agreement is not required for actions taken by ARCH with respect to a Member.

    •
  • Once the investigation and any disciplinary process has concluded, I will be notified of the
    outcome.

    •
  • There is no appeal of a decision of ARCH with respect to my complaint.

    •
  • ARCH requires Members to have Professional Liability Insurance and Commercial General Liability
    Insurance and is not legally liable for the conduct of Members.

    		•
     
    Name: ___________________________
    Date:   ___________________________