What Information Do We Need

In order to address a complaint, we require a signed complaint form from you that gives us as much information as possible to properly deal with the issue. You may want to speak to the Director of Professional Conduct for support.

We will need your name, address, phone number and/or email address as contact information.

Include the name of the nurse and your relationship with the nurse (provided care to you or to a relative, employer, etc.)

Provide as much detail as you can about the incident(s) and if possible include the following:

  1. The nurse’s actions that caused concern.
  2. The date and time of the incident(s).
  3. The location where the incident(s) occurred.
  4. The name of anyone who may have witnessed the incident(s).
  5. Details about who you have spoken to about your concerns, include names and contact information.
  6. Any documented evidence you have with respect to your complaint, such as notes you made.
  7. If you are a nursing employer, please include the nurse’s work history with you.
  8. If you are an employer or a nursing colleague of the nurse do not send any patient information or documentation. We will gather any documents we think we may need.

I am looking for…

Quicklinks

Contact Us

Office Hours
Monday – Friday  8:30 am – 4:30 pm
Saturday & Sunday  Closed

PO Box 2757
Yellowknife, NT  X1A 2R1
Phone: 867-873-2745
Fax: 867-873-2336

Office Location
483 Range Lake Road
X1A 3R9

Contact form