Submitting a Complaint

There are some basic requirements that must be made BEFORE we can process your complaint:

  1. Your complaint must be made in writing and signed by you. You may wish to file your complaint by completing this Complaint Form, but you need not use this form as long as your complaint is in writing and is signed.
  2. You must complete the Authorization for release of Medical Information form. It is required and must be signed by you.
  3. If your concern involves more than one physician, a separate letter/form is required for each physician about whom you wish to complain.
  4. Be sure to include: 
    • Your name, address, postal code, telephone number and personal health identification number (9 digit) from your Manitoba Health card;
    • Name of the physician of concern;
    • any dates that relate to your complaint
    • the name and address of other caregivers, including physicians, from whom information could be obtained;
    • The name of any hospitals attended during the period of complaint and the dates upon which you were treated at that hospital;
    • A clear description of the complaint about the physician;
    • If you are not the patient, state your authority to legally act on behalf of the individual. If the patient is deceased, please provide documentation showing your status as executor/executrix of their estate.
  5. You may mail, deliver, fax, or email your signed complaint and consent form.
    • By mail to:

      The College of Physicians and Surgeons of Manitoba

      Attn: Complaints Department

      1000-1661 Portage Avenue

      Winnipeg MB   R3J 3T7

    • By fax to: (204) 774-0750
    • By email to: complaints@cpsm.mb.ca.. If you use this option, be sure to attach the SIGNED forms.

 

For a detailed explanation of the complaints process, please refer to Step-by-Step Through the Process.

If you have any questions or require any clarification on completing this form, please contact the Complaints Department at the College using the above contact information .