Grievance Form

A grievance involves a perceived violation of rights, rules, or a contract such as the SOBI Code of Ethics. Grievances are received by the SOBI office, then confidentially reviewed and researched by the Professional Conduct Committee (PCC). The PCC submits a recommendation of action to the SOBI Board of Directors.
 
 
Current Date ?
 
 

Complainant Contact Information (person filing)

First Name
Last Name
Address
City
State
Zip
Phone
Email
Best time to reach you
 

Respondent Contact Information (if known)

First Name
Last Name
Phone
Email
 

Date and Location of the Grievance

Date ?
Location
 

Nature and Outline of the Grievance

Please be specific. Did the incident involve a breach of the Code of Ethics? If so, which one and how?
 
The information given above is true and accurate to the best of my knowledge. I realize the serious nature of filing a grievance. I recognize that the Professional Conduct Committee will not be able to take action without my cooperation to provide additional information if needed.
Name
Initials
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