COAMFTE Complaint Form

Please utilize this form when submitting a complaint against a COAMFTE accredited program.

To be considered by COAMFTE, the complaint must allege, directly or indirectly, some violation of the accreditation standards under which the program was accredited. Complaints are not anonymous and will be shared with the program for response. The COAMFTE Accreditation Standards can be found here. The complete complaint procedure can be found on page 43 of the COAMFTE Accreditation Manual.

If you have any questions please email coa@aamft.org.

1. Contact Information *This question is required.

Your Name

Your Email Address This question requires a valid email address.

Your Phone Number

2. Program Information *This question is required.Please complete the information below for the program for which you are submitting a complaint against.

Institution (e.g. University of XYZ)

Program Name (e.g. Couple and Family Therapy Program)

Degree Level (PhD, MA, MS, etc.)

PhD
MA
MS
PDI
Other - Write In (Required) Please enter an 'other' value for this selection. * This question is required.

3. Complaint Information
*This question is required.

When did the facts or circumstances that form the basis of the complaint occur? *This question is required.

Is this a complaint or grievance the subject of litigation or administrative proceedings that is currently pending or under review? *This question is required.

If yes, please provide a description of any pending reviews or investigations by the subject program, institution, other accrediting organization, administrative proceedings by a government entity, or any pending litigation related to the subject matter of the complaint. *This question is required.

Have you filed a complaint or grievance in accordance with the program’s / institution’s complaint/grievance policy and procedures? *This question is required.

Please provide any information pertaining your efforts to resolve the complaint through the institution’s grievance procedures. *This question is required.

Please identify the issue(s) for which you are submitting this complaint *This question is required.

Please identify the specific Standard(s) and Key Element(s) the issue(s) listed above apply to *This question is required.

Please explain how the issue(s) noted above and the Standard(s) and Key Element(s) noted above relate to one another

Please provide all relevant names and dates and a brief description of the actions forming the basis of the complaint. *This question is required.

4. Please upload any supporting documentation or materials related to your complaint that support the allegations. Please note that supporting documentation must be uploaded as one PDF document with bookmarks to each element/document. (NOT OPTIONAL) *This question is required.

File: {{filename}} delete

5. Waiver of Confidentiality and Authorization to Release Information and Use Name: *This question is required.

(1) I certify that the information I have provided is correct to the best of my knowledge; and
(2) I authorize the release of information contained in the Complaint, including information obtained in the course of investigating and adjudicating the Complaint, and the use of my name in the investigation of the Complaint by COAMFTE, in accordance with the COAMFTE Complaint Procedures.

Clear

Signature of

Date Signed