Submit a Complaint
To submit a complaint, please note:
- If your complaint is about more than one doctor, a separate letter or form is needed for each one.
- If you are not the patient, you must have the legal authority to act on behalf of the individual. If the patient is deceased, you will need to provide documentation showing your status as executor/executrix of their estate.
You can submit your complaint online (new window will open):
You can also mail, email, fax or drop off your complaint.
1. You can print and fill in the forms below. Both need your signature.
Authorization for Release of Medical Information Form.
2. If you prefer, you can write a letter that describes your concern. CPSM has authority to access medical information to investigate your complaint, but unless there are exceptional circumstances we will not do so without consent. For this reason we ask for your consent to release the information to CPSM. We can mail this form to you. Please contact us at (204) 774-4344 (ext. 111) or at email@example.com.
Be sure to include in your letter:
· Your name, address, postal code, and telephone number
· Your email address if you have one
· Information from your Manitoba Health card;
o 6-digit number
o Personal health identification number (9-digit)
· Name of the doctor (or physician/clinical assistant) in your complaint;
· A clear description of the complaint, including:
o What happened
o When it happened
o Where it happened
o Names of other people who may have information about your concern
o What you would like us to address
Our mailing address is:
The College of Physicians and Surgeons of Manitoba
Attn: Complaints Department
1000-1661 Portage Avenue
Winnipeg MB R3J 3T7
Email: firstname.lastname@example.org. If you send documents this way, be sure to attach the SIGNED forms.
If you have any questions:
Please contact us at 204-774-4344 ext. 111 or at email@example.com.
For a detailed explanation of the complaints process, please refer to Step-by-Step Through the Process.