Enquiry Request Form

You can submit an enquiry request to OPPQ’s Office of the Syndic if you believe a member has violated the Professional Code, the Code of Ethics for Physiotherapists and physiotherapy technologists, or any other OPPQ regulation.

Identification of professional

Last name*

First name*

Civic number*

Apartment number

Street and number*

City*

Postal code*

Phone number*

Job title

Physiotherapist

Physiotherapy technologist

Claimant information

Last name*

First name*

Civic number*

Apartment number

Street and number*

City*

Postal code*

Email*

Phone number*

Reason for requesting an enquiry

Briefly explain the nature of the alleged offence.*

Attach any supporting documents you may have.

Drop files here or

Accepted file types: doc, docx, xls, pdf, txt, jpg, jpeg, gif, png, Max. file size: 16 MB.

Claimant objectives

Explain what your expectations are.

Signature

Acceptation*

I, the undersigned, certify that the information provided is true to the best of my knowledge. I agree to cooperate, testify, and provide all information, documents, or other information required for the purposes of the enquiry until its conclusion.

Full name of claimant*

Date*

Phone

This field is for validation purposes and should be left unchanged.