How to File a Complaint with the Physician Assistant Committee

I Need To:

Right Column

There are three ways that you can file a complaint:

Call to have a Complaint Form mailed to you (916) 263-2670, OR
Use the On-line Complaint Form, OR
Download and Print a Complaint Form

Information Collection, Use and Access

Collection and Use of Personal Information.
The Department of Consumer Affairs collects the information requested on this form as authorized by business and Professions Code Section 325 and 326. The Department uses this information to follow up on your complaint.

Providing Personal Information Is Voluntary.
You do not have to provide the personal information requested. If you do not wish to provide personal information, such as your name, home address, or home telephone number, you may remain anonymous. In that case, however, we may not be able to contact you or help you resolve your complaint.

Access to Your Information.
You may review the records maintained by the Department that contain your personal information, as permitted by the Information Practices Act. See below for contact information.

Possible Disclosure of Personal Information.
In order to follow up on your complaint, we may need to share the information you give us with the business you complained about or with other government agencies. This may include sharing personal information you gave us.

The information you provide may also be disclosed in the following circumstances:

In response to a public Records Act request, as allowed by the Information Practices Act;
To another government agency a required by state and federal law;
In response to a court or administrative order, a subpoena, or a search warrant.

Contact Information.
For questions on this notice, the Department's privacy policy, or access to your records, you may want to contact the California Office of Privacy Protection, 1625 North Market, Suite N324, Sacramento, CA, 95834, 866-785-9663, or e-mail privacy@dca.ca.gov.