Dental Examinations Executive - Complaint Submission Form

Dental Examinations Executive - Complaint Submission Form
This form should be completed by Dental Examinations Executive candidates wishing to make a complaint. Candidates are advised to read the Complaints Policy and Procedure (Candidate Information - Dental Examinations Executive) in advance of completing and submitting this form.
Full name of complainant

First NameLast Name
Relationship of complainant to Executive
Email address
example@example.com
GMC/IMC number (where applicable)
If your complaint is related to a specific examination, please also provide the following information:
Name of examination
Date of examination

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Location of examination