INFORMATION COLLECTION, ACCESS AND DISCLOSURE
The information you provide on this complaint form is maintained by the Executive Office of the Board of Acupuncture, 1747 North Market Blvd, Suite 180, Sacramento, CA 95834. The information is requested pursuant to Business and Professions Code Sections 325 and 326.
Submission of all information requested is voluntary. However, omission of any required information will result in your complaint being rejected as incomplete and it will not be successfully submitted.
Your completed complaint form becomes the property of the Board and will be used by authorized personnel as appropriate. Information concerning your complaint may be transferred to other governmental or law enforcement agencies.
You have the right to review the records maintained on you by the department unless the records are exempt by section 1798.40 of the Civil Code. You may gain access to the information by contacting the department at the above address.