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Provider Complaint Form

Provider Complaint Form

The purpose of this form is to submit complaints regarding CTEC approved education providers. Please complete the appropriate information below related to your compaint and then click submit. You may also download and print a form to complete and send via mail.

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Sumitted By:

Name

Address

City, State Zip

Phone

Email

Check One

CRTP - Enter Number:

CTEC Provider - Enter Provider Number:

Other (Describe relationship with CTEC):

Provider Information:

Name of Provider

Provider Number (if known)

Name of Course/Seminar

Course/Seminar CTEC Number (if known)

Subject of Complaint (check all that apply)

Course/Seminar material was not current

Course/Seminar material contained technical errors

Course/Seminar had little, if any educational value

Course CPE award was excessive

CPE was not reported to CTEC

Course/Seminar was not as advertised

Provider did not honor the stated refund policy

Provider did not provide an evaluation form

Self-study course did not include review questions

Self-study course final included true/false, yes/no, A/B questions and/or multiple choice questions with fewer than four answer options

Provider Complaint Details

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