To submit a complaint regarding an alleged violation of the ASHA Code of Ethics, please complete all required sections in the complaint form below. For additional information regarding the ASHA Board of Ethics complaint process, please review Filing a Complaint of Alleged Violation of the ASHA Code of Ethics or Assistants Code of Conduct.
Your written summary should include a detailed account of the facts and circumstances that led to this complaint. Additionally, you should list the sections of the ASHA Code of Ethics or Assistants Code of Conduct that you believe were violated. Be sure to attach any supporting documentation to this complaint form. If you have more documentation than the complaint form will accept, you can send additional attachments to the ASHA Ethics Office at: firstname.lastname@example.org. When sending additional documentation, the email subject line should contain your name so that the additional content can be joined with your complaint submission. Your written summary should also list the sections of the ASHA Code of Ethics or Assistants Code of Conduct that you believe were violated.
Anonymous complaints will not be accepted. Additionally, the Board of Ethics only accepts complaints against individuals who are ASHA members, certificate holders, or applicants for ASHA certification or membership. The Board of Ethics will not review complaints against companies, institutions, or individuals not under its jurisdiction.
By signing this Board of Ethics Complaint Form, you agree to the terms set forth in the Waiver of Confidentiality and Privacy Rights and Non-Disclosure sections set forth below and you affirm the Complainant Affirmations at the bottom of this form.
If you have any questions regarding the complaint process, please reach out to the ASHA Ethics Office at email@example.com.
After clicking “Submit” you will be redirected to the DocuSign website to digitally sign your submission. Do not exit your screen until you have completed the DocuSign signature process. We recommend that you review these DocuSign instructions prior to submitting this form.
*Denotes required field