File a complaint
Complaints Form relating to Restrictive Practices
1. DETAILS OF THE COMPLAINANT
1.1 Information for identification
1.1.1 Do you request non-disclosure of your identity or of the fact that you have submitted a complaint to the CTC?
(Please tick the appropriate answer)
Yes
No
1.1.2 Details of the person filing the complaint
(Please tick the appropriate answer)
Self
Legal representative of the complainant
Proxy of the complainant
Name
Physical Address
Postal Address
Telephone number
Email-address
1.1.3 The complainant is an:
(Please tick the appropriate answer)
Organisation or Company
Individual
Other
1.1.4 The complainant's
Name
Physical Address
Postal Address
Telephone number
Email-address
1.1.5 Contact details of the person to whom CTC should send any correspondences
Name
Physical Address
Postal Address
Telephone number
Email-address
Next page