Complaint Form

Complaints are received by the SOBI office, then reviewed and handled by the Board of Directors. The complainant decides on the level of communication between the other party and the Board, including the option of no communication. The complainant's information is kept confidential outside of the Board and SOBI office unless the complainant decides differently.
 
 
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 Complaint

Date ?
Location
 

Nature and Outline of the Complaint

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 complaint. I recognize that the Board of Directors may not be able to take action without my cooperation to provide additional information if needed.
Name
Initials
   - denotes required fields