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Click ‘Get Form’ to open it in the editor.
Begin by filling out the 'Complaint Registered Against' section. Enter the name of the dental office, your name, address, city, state, zip code, and office phone number.
In the 'Person Registering Complaint' section, select your title (Mr., Mrs., Ms.) and provide your relationship to the patient along with your contact information.
Complete the 'Patient Name' section with the patient's details including their date of birth and gender. Indicate if you have legal authority to act on their behalf.
Detail your complaint in the 'Details of Complaint' section. Include dates of visits and describe your concerns thoroughly. Attach any supporting documents as needed.
Sign and date the form at the bottom before submitting it through our platform for processing.

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What is an unethical situation in a dental office?

Tooth decay is also known as dental caries or dental cavities. It is the most common dental problem that dentists see in patients. Practically everyone, at some point in their life, has experienced tooth decay. Tooth decay occurs when bacteria form a film, called plaque, on the surface of teeth.

How do I report a dental office in California?

How to File a Complaint with the Dental Board Call to have a Complaint Form mailed to you (916) 263-2300, OR. Use the On-line Complaint Form, OR. Download and Print a Complaint Form.

What is the most common dental complaint?

Unprofessional Conduct (violation): Serious violations of the Dental Practice Act or unethical business practices, such as client abandonment, failure to release or return records, or bdocHub of confidentiality.

How to file a complaint against a dental office in California?

A dentist who recommends or performs unnecessary dental services or procedures is engaged in unethical conduct. The dentists ethical obligation in this matter applies regardless of the type of practice arrangement or contractual obligations in which he or she provides patient care.