COVID-19: I am a Patient / I am a Professional

Identification of the person or organization being reported (not an OPPQ member)

Claimant information

Restricted activity you believe is being practiced illegally

Choose the applicable activities (select all that apply)

Title you believe is being used illegally

Choose the applicable titles (select all that apply)

Why you are filing a report

Evidence of Illegal Practice

(business card, advertisement, website, Facebook page, invoice for services, etc.)
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Accepted file types: doc, docx, xls, pdf, txt, jpg, jpeg, gif, png, Max. file size: 4 MB.
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