File a Concern / Complaint

Have a concern or complaint regarding a respiratory therapist? Submit your concern online in confidence to the Registrar. (For assistance or difficulty completing the form, please contact the Registrar and Deputy Registract by clicking here or at registrar@nsrrt.ca and deputyregistrar@nsrrt.ca)

Contact Information

First Name:(*)

Please enter your first name.

Your Email(*)

Please let us know your email address.

Last Name:(*)

Please enter your last name.

Telephone:(*)

Please enter your phone number.

Civic Address:(*)

Please enter your full civic address.

Details of Concern

Number of Respiratory Therapists Involved:(*)

Please select the number of respiratory therapists involved in the incident.

Respiratory Therapist's First Name:(*)

Please enter the first name of the Respiratory Therapist involved.

Second Respiratory Therapist's First Name:(*)

Please enter the first name of the second Respiratory Therapist involved.

Third Respiratory Therapist's First Name:(*)

Please enter the first name of the third Respiratory Therapist involved.

Location of the Incident:(*)

Please enter the location of the incident.

Respiratory Therapist's Last Name:(*)

Please enter the last name of the Respiratory Therapist involved.

Second Respiratory Therapist's Last Name:(*)

Please enter the last name of the second Respiratory Therapist involved.

Third Respiratory Therapist's Last Name:(*)

Please enter the last name of the third Respiratory Therapist involved.

Date of the incident(*)

Please select the date the incident occurred.

Description of the incident(*)

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Please describe the incident.

Please prove you are human.(*)

Please prove you are human.

File a Concern / Complaint

Contact Information

Details of Concern

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