Complaint Form

You can use this form to lodge a complaint against a psychologist.
All information transmitted will be treated confidentially. The person concerned may consult the entire complaint file as part of their defence, including this complaint form. .

If you prefer, you can also print this form:
In NL version: print this form
In FR version : print this form
and send it by post to the following address :
Commission of Psychologists
For the attention of the Disciplinary Board
Avenue des Arts 3
1210 Bruxelles

If you have any questions about the disciplinary procedure, please send an e-mail to plainte@compsy.be

* : indicates that the field is required

1. Your contact details

Lastname *

Firstname *

Gender *

Address *

Email *

Phone

2. Complaint Subject's Contact Info

Psychologist lastname *

Psychologist firstname *

Psychologist gender

Psychologist professional address

Psychologist email

Psychologist phone

What is the title of the person? *

Psychologist

Other:

Is this person registered with the Commission of Psychologists as a psychologist? * (You can check this using the search function using the search function)

Yes - registration number:

I don't know

3. Your complaint

Location of the fact *

Date of the fact (When did the events occur?) *

Description of the facts * (For info code of ethics)

Have you already filed a complaint with another authority, informed another authority of the facts or is there an investigation underway with another authority? *

Yes - with the following authority:

No, but I will still inform the following authority:

Have you any other information that you would like to share with the Disciplinary Board?

If you have any evidence supporting your complaint, you can add it in the appendix below (e.g. emails, letters, statements, reports, etc.). Please number and briefly describe them below (please limit them to the information strictly necessary for the processing of your complaint)