Report Misrepresentation - Canadian Dermatology Association

Report a physician claiming to be a dermatologist or who is providing unlicensed dermatologic care

False, misleading or deceptive claims (by inclusion or omission), advertisements and/or communications by a physician about his or her professional qualifications whether directly or indirectly to the public are not permitted and can be submitted to a Provincial College of Physicians and Surgeons for investigation.

To report someone misrepresenting himself or herself as a dermatologist, please complete and submit the form below. The CDA will advise the appropriate College of the reported incident. At all times, your personal information will be kept confidential.

A. Physician of concern

Full Name(Required)

First Name (mandatory) Last Name (mandatory)

License Number

Certifications

地址(Required)

Full Address Province

B. Details

Date of incident or discovery (mandatory)(Required)

Description of incident to be investigated (mandatory)(Required)

Description of any efforts made to resolve the incident (mandatory)(Required)

If the following is relevant, please complete.

Clinic/Practice Name

Is this a private practice or a group practice?

Website

社交媒体的应用和处理

C. Supporting documents and materials

File Upload

Drop files here or

Max. file size: 2 MB, Max. files: 4.

Provide all documents and materials (e.g. copy of letterhead, copy of advertising, photo of signage, etc.) to validate the incident.

D. Contact information for CDA purposes only.

Full Name(Required)

First Name (mandatory) Last Name (mandatory)

Email (mandatory)(Required)

Please Confrim

I acknowledge I may be asked to provide further details and/or evidence relating to this incident.

I certify that the above statements are true and correct to the best of my knowledge.

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