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Sample Secure Deposit Box Submission Form
Submit Your Complaint
To initiate a complaint against a midwife, please provide the following information in a written or recorded form, such as a letter, or audio or video recording:
- Your full name
- Your mailing address, email and phone number
- Name(s) of midwife/midwives you are complaining about
- Name of the midwifery practice associated with your complaint
- Date(s) of the incident(s)
- Description of events, and the details of the complaint in your words
- If applicable, the name(s) of the hospitals or other health clinics related to your complaint
If you would like to submit your complaint as an attachment, please include the information listed above, as well as any additional supporting evidence relevant to your complaint and upload it to our secure deposit box below.
Secure Deposit Box submission form
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