1. Acknowledge that you are lodging a written formal complaint and understand that it is the policy of the Regulator to investigate all written formal complaints; and
2. Give permission to the Regulator to conduct a recorded interview with the Investigator; and
3. Give permission to the Regulator to release your name, any named witnesses and share some or all the information and copies of documents that it receives from you, and any other person to:
4. Certify that the details and information provided are true, accurate and complete to the best of your knowledge; and
5. Disciplinary hearings are open to the public. It may be necessary to disclose your personal information (name, content of your complaint, etc.) during a hearing, should your complaint be referred to the Discipline Committee.