Guidelines and Procedures

Guidelines and Procedures
for
Processing Complaints
(with complaint form)

Developed and promulgated by the
Commission on Rehabilitation Counselor Certification (CRCC^®)
for use in processing allegations of violation of the CRCC
Code of Professional Ethics for Rehabilitation Counselors
by Certified Rehabilitation Counselors (CRC^®s) and
Canadian Certified Rehabilitation Counselors (CCRC^®s)

CRCC
300 N. Martingale Road, Suite 460
Schaumburg, IL 60173
(847) 944-1325
http://www.crccertification.com

CRCC

Guidelines and Procedures for Processing Complaints

Release of Information

Individuals who choose to file a complaint under these Guidelines and Procedures for Processing Complaints will be required to grant permission to the Certificant (as defined below) to release all records of interactions to the CRCC Ethics Committee and to answer all questions the Committee may ask concerning those interactions. Thus, the entire contents of an individual’s file, including documents from other service providers, may become part of the evidence. Furthermore, they will be required to grant permission to allow the CRCC Ethics Committee to send copies to the Certificant of any materials submitted in conjunction with the complaint.

Individuals who file a complaint but are not the client and yet use client information to support their claim, must obtain written permission from the client to submit the information, or must remove all identifying information from the materials submitted in conjunction with the complaint.

Statement of Purpose

1. The Commission on Rehabilitation Counselor Certification is dedicated to the international promotion of professional rehabilitation counselor certification through credentialing to advance the quality of service provided to persons with disabilities.

2. The Commission, in furthering its objectives and through the CRCC Ethics Committee, administers the Code of Professional Ethics for Rehabilitation Counselors that has been developed and approved by the Commission. The intent of the Commission is to monitor the professional conduct of its certificants to promote sound ethical practices. CRCC does not, however, warrant the performance of any individual.

3. These Guidelines and Procedures for Processing Complaints facilitate the work of the CRCC Ethics Committee by specifying procedures for (a) processing cases of alleged violation of the CRCC Code of Professional Ethics for Rehabilitation Counselors, (b) sanctioning certificants, and (c) appeals.

Section A: Definitions

1. Certificant: As used in these Guidelines only, the “Certificant” shall refer to the CRC/CCRC who is alleged to have violated the Code.

2. Code: The CRCC Code of Professional Ethics for Rehabilitation Counselors.

3. Commission or CRCC: The Commission on Rehabilitation Counselor Certification.

4. Committee: The CRCC Ethics Committee.

5. CRC/CCRC: Certified Rehabilitation Counselor/Canadian Certified Rehabilitation Counselor.

6. Guidelines: These CRCC Guidelines and Procedures for Processing Complaints.

Section B: Ethics Committee

1. Membership – The Ethics Committee is a standing Committee of the Commission. The Committee consists of at least four (4), but not more than six (6) Commissioners, appointed by the Chair of the Commission and confirmed by a majority vote of the Commission, including the individual appointed as Chair of the Committee. The Chair of the Commission shall fill any vacancy occurring on the Committee.

2. Meetings – The Committee may meet in person or by telephone conference a minimum of four (4) times per year for processing complaints.

3. Quorum – A quorum of three members of the Committee is necessary to conduct a hearing or any other business to come before the Committee.

4. Disqualification – In the event any member of the Committee has a personal interest in the case or has any knowledge of the case other than what has been provided to all Committee members, he/she shall withdraw from hearing the case. In the event that the Chair of the Committee shall withdraw, the Commission Chair shall appoint another Committee member to act as Chair of the Committee.

5. Replacements – If a Committee member excuses himself/herself from a complaint and insufficient members are available to conduct business, the Chair of the Commission shall appoint a former CRCC Commissioner, who is a CRC/CCRC, to act as a member of the Committee. In the event that no former CRCC Commissioner is available to act as a member of the Committee, the Chair of the Commission shall appoint a member who is a CRC/CCRC until a sufficient number of members is obtained that constitutes a quorum.

6. General Responsibilities – The Ethics Committee is responsible for (a) educating CRCs/CCRCs and the general public as to the provisions of the Code; (b) periodically reviewing and recommending changes in the Code as well as these Guidelines; (c) receiving and processing complaints of alleged violations of the Code; and (d) receiving and processing questions with respect to the Code. The Committee members have an obligation to act in an unbiased manner, to work expeditiously, to safeguard the confidentiality of the Committee’s activities, and to follow procedures established to protect the rights of all individuals involved.

7. Jurisdiction – The Committee has jurisdiction to consider whether an individual has violated the Code if the individual is a current CRC/CCRC. In the event that the CRCC receives a complaint concerning an individual who does not possess a CRC or CCRC designation, a representative of CRCC shall inform the complainant and may refer the complainant to an appropriate authority. Should a Certificant attempt to relinquish certification during the course of any case, CRCC reserves the right to continue the matter for a final and binding resolution according to these rules.

Section C: Ethics Complaints

1. Persons Who May File – The Committee shall accept complaints that a Certificant has violated one or more Standards of the Code from the following:

a. CRC/CCRCs or members of the general public who have reason to believe that a Certificant has violated the Code.

b. The Committee Chair when the Committee has reason to believe through reliable information received or obtained by it that a Certificant has violated the Code.

2. Complaint Submission Requirements – The Committee shall accept only signed, written complaints on the CRCC Ethics Complaint Form attached to these Guidelines. If telephone inquiries from individuals are received regarding the filing of complaints, the individuals calling shall be informed of the signed, written communication requirement and asked to comply. If written complaints are submitted that either do not include the required complaint form or if the complaint form is not completed in its entirety to include supporting documentation to substantiate the allegations, the complainant will be informed in writing of the need to comply with these requirements before the complaint will be presented to the CRCC Ethics Committee. If the complainant does not respond within thirty days (30) to CRCC’s request to comply with the requirements, the case file will automatically be closed without action.

3. Correspondence on Complaints – All correspondence related to a complaint must be in writing and addressed to the Ethics Committee, CRCC, 300 N. Martingale Road, Suite 460, Schaumburg, Illinois 60173, and must be marked “Confidential.” This process is necessary to protect the confidentiality of the complainant and the Certificant.

4. Duties of CRCs/CCRCs – All CRCs/CCRCs are pledged, in accordance with the Code, to cooperate with proceedings of the CRCC for any alleged violation of the Code.

5. Time Lines – The time lines set forth in these standards are guidelines only and have been established to provide a reasonable framework for processing complaints. The Committee shall grant an extension of a deadline requested by a Certificant or complainant only when justified by unusual circumstances. The Committee may, in its discretion, delay or postpone its review of any case.

6. Administration of Complaints – The responsibilities of the Committee with respect to ethics complaints shall include, but not be limited to, the following:

a. Review the complaint that has been received. The Committee will not consider prior complaints against a Certificant during the adjudication process of a current complaint except at the time of final deliberations if a finding of a violation of the Code occurs, in which case the Committee make take into consideration a prior finding of violation;

b. Determine whether the alleged behavior, if true, would violate the Code, and whether the Committee should accept the complaint under these Guidelines;

c. If the Committee determines that the complaint contains insufficient information to make a fair determination of whether the behavior alleged in the complaint would be cause for action by the Committee, the Committee may request further written information from the complainant or other person;

d. Notify the complainant that the Committee has determined that no action shall be taken; or, if action is to be taken, notify the complainant and the Certificant of acceptance of the complaint; and

e. When appropriate, the Committee shall arrange for legal advice with the assistance of the CRCC Chief Executive Officer.

7. Withdrawal of Complaints – If the Certificant voluntarily relinquishes certification or if the Certificant or complainant fails to cooperate with an ethical inquiry in any way, the CRCC shall, at its discretion, continue its investigation, noting in its final report the circumstances of the Certificant’s or complainant’s failure to cooperate. The Committee, in its sole discretion, may terminate the complaint of an uncooperative complainant. Even if the complainant and Certificant agree to discontinue the complaint process, the Committee may, at its discretion, complete the adjudication process if available evidence indicates that this is warranted.

8. Certificant Response – If a complaint is accepted, the Certificant shall be asked to respond in writing to the complaint against him/her, addressing each of the following:

a. Acknowledge the section of the Code which he/she has been accused of having violated; and

b. Submit any fact affidavits, documents, or written arguments that he/she wishes to be considered by the Committee in reviewing the complaint.

The Certificant shall be informed that if he/she wants to respond, he/she must do so in writingwithin thirty (30) days from the date of notification. If a Certificant fails to respond in writing to a request from the Committee, the Committee may impose sanctions on the basis of the complaint alone. Should the Committee request further information from the Certificant, the Certificant shall be given thirty (30) days from the date of the request to respond.

9. Preliminary Disposition of Complaint – After receiving the response of the Certificant, Committee members shall be provided copies of the response and supporting fact affidavits, documents, or written arguments provided by the Certificant and others. At the next meeting or teleconference of the Committee, the Committee shall discuss the complaint, response and any supporting documentation. On the basis of the complaint and the Certificant’s response, the Committee must act as follows:

a. If no violation is found, the case shall be closed and all parties shall be notified of case closure in writing; or

b. If reasonable basis is found to exist for any violation alleged in the complaint, all parties shall be notified in writing. Upon a finding of reasonable basis, the Certificant may make a written request for a hearing before the Committee or the Committee, in its discretion, may initiate a hearing.

Section D: Ethics Hearings

1. Initiation – If a hearing has been requested by the Certificant or initiated by the Committee, the Committee Chair shall schedule a hearing on the case and notify the complainant and the Certificant of their right to attend the hearing with legal counsel. The hearing shall be held before the Committee.

2. Purpose –

a. A hearing shall be conducted to determine whether a violation of the Code has occurred and, if so, to determine appropriate disciplinary action.

b. The Committee shall be guided in its deliberations by principles of basic fairness and professionalism, and shall keep its deliberations as confidential as possible, except as provided herein.

3. Notice to Parties – The Certificant or his/her legal counsel and the complainant shall be advised in writing by the Chair of the Committee of the time and place for the hearing.

4. Conduct of Hearing –

a. The location of the hearing shall be determined at the discretion of the Committee. Parties to the complaint, including witnesses, may participate by telephone. The Committee shall provide a private room to conduct the hearing and no observers, other than appropriate CRCC staff, or recording devices other than a recording device used by the Committee shall be permitted.

b. The Committee Chair administering the complaint shall preside over the hearing and deliberations of the Committee. At the conclusion of the hearing and deliberations of the Committee, the Commission shall promptly issue written notice to the Certificant of the Committee’s decision. The Commission shall also notify the complainant in writing of the disposition of the complaint.

c. A record of the hearing shall be made and preserved until all appeals are completed or the appeals period has expired. The record shall consist of a summary of testimony received or a verbatim transcript, at the discretion of the Committee. Documents presented in evidence shall be retained, at CRCC’s administrative office, as set forth in Section I below.

d. The Certificant and the complainant shall be entitled to have legal counsel or a representative present to advise and represent them throughout the hearing. Legal counsel for CRCC may also be present at the hearing to advise the Committee and shall have the privilege of the floor.

e. Either party shall have the right to call witnesses to substantiate his/her version of the case.

f. The Committee shall have the right to call witnesses it believes may provide further insight into the matter.

g. Witnesses shall not be present during the hearing except when they are called upon to testify and shall be excused upon completion of their testimony and any cross-examination.

h. The Chair of the Committee shall allow questions to be asked of any witness by members of the Committee and, in its discretion, by the opposition if such questions and testimony are relevant to the issues in the case.

i. The Chair administering the complaint shall determine what questions and testimony are relevant to the case. Should the hearing be subject to irrelevant testimony, the Chair may call a brief recess until order can be restored.

j. Both the complainant and the Certificant, and any witnesses and legal counsel that they may have must pay their own expenses. CRCC shall pay the expenses of the Committee members. Parties initiating telephone contact shall assume the expenses related to the calls.

k. If the Certificant fails to appear at the hearing, the Committee shall decide the complaint and determine what testimony it shall hear on record. Failure of the Certificant to appear at the hearing shall not be viewed by the Committee as sufficient grounds alone for taking disciplinary action.

5. Presentation of Evidence –

a. The Standard Order of Testimony for CRCC Hearings shall be as follows, as applicable:

Activity Time

Convening of Hearing

Opening Statement by Ethics Committee Chair

Opening Statement by Certificant’s Attorney or Certificant 000000i10 Minutes

Testimony from Complainant 20 Minutes

Questioning of Complainant by Committee & CRCC Attorney

Questioning of Complainant by Certificant’s Attorney or Certificant 000000015 Minutes

Testimony from Complainant’s Witnesses 30 Minutes

Questioning of Complainant’s Witnesses by Committee & CRCC Attorney

Testimony from Certificant 20 Minutes

Questioning of Certificant by Committee & CRCC Attorney

Questioning of Certificant by Complainant’s Attorney or Complainant 15 Minutes

Testimony from Certificant’s Witnesses i30 Minutes

Questioning of Certificant’s Witnesses by Committee & CRCC Attorney

Closing Statement from Certificant’s Attorney or Certificant 05 Minutes

Conclusion of Hearing

b. The Chair of the Committee shall have the authority to modify the Standard Order of Testimony for any hearing, in the event the Chair deems it necessary or appropriate.

c. The Certificant may refuse to testify at a hearing and shall not be found in violation of the Code simply for refusing to testify. Once the Certificant chooses to testify, however, he/she may be questioned by the complainant and members of the Committee, subject to the constitutional rights of the Certificant.

d. Testimony that is merely cumulative or repetitious may, at the discretion of the Committee Chair, be excluded.

e. All parties providing testimony shall be required to attest to the veracity of their statements.

f. Any written documentation submitted by the parties in connection with a hearing after the deadlines determined by the Committee may, at the Committee’s discretion, be excluded or receive limited consideration.

6. Relevancy of Evidence –

a. The Committee hearing is not a court of law and is not required to observe formal rules of evidence. Evidence that would be inadmissible in a court of law may be admissible in the hearing before the Committee, if it is relevant to the case. Therefore, if the evidence offered tends to explain, clarify, or refute any of the important facts of the case, it should be considered.

b. The Committee shall not consider evidence or testimony for the purpose of supporting any charge that was not set forth in the notice of the hearing or that is not relevant to the issues of the case.

7. Burden of Proof –

a. The burden of proving a violation of the Code is on the complainant.

b. Although the charge(s) need not be proved “beyond a reasonable doubt,” a Committee finding that a Certificant has violated the Code must be supported by substantial, objective, and believable evidence.

8. Deliberations of the Committee –

a. After the hearing is completed, the Committee shall meet in a closed session to review the evidence presented and reach a conclusion. CRCC legal counsel may attend the closed session to advise the Committee if the Committee so desires.

b. The Committee shall be the sole judge of the facts and shall weigh the evidence presented and assess the credibility of the witnesses. The decision of a majority of the members of the Committee present shall be the decision of the Committee and the Commission. The Chair of the Committee shall vote only to break a tie or when the Committee consists of three members.

c. Only members of the Committee who were present throughout the entire hearing shall be eligible to vote.

9. Committee Decisions –

a. The Committee shall first resolve the issue of whether the Certificant violated the Code. Applying the burden of proof in Subsection 7 above, the Committee shall vote by secret ballot, unless all of the members of the Committee entitled to vote consent to an oral vote.

b. In the event the Committee does not find that the Certificant has violated the Code, the charges shall be dismissed. If the Committee finds the Certificant has violated the Code, it must then determine what actions or sanctions shall be imposed.

Section E: Committee Actions and Sanctions

1. Permissible Actions and Sanctions –

a. Letter of Instruction. In the event it is determined that the Code has been violated, the Committee shall consider the degree of harm and significant mitigating circumstances and may issue of letter of instruction, which is not a sanction.

b. Sanctions. In the event it is determined that the Code has been violated, and a letter of instruction is not appropriate, the Committee shall impose one or a combination of the possible sanctions that follow:

i. Reprimand. The Committee may stipulate remedial requirements.

ii. Probation for a specified period of time subject to Committee review of compliance. The Committee may impose remedial requirements to be completed within a specified period of time.

iii. Suspension from CRC/CCRC certification for a specified period of time subject to Committee review of compliance. The Committee may impose remedial requirements to be completed within a specified period of time.

iv. Revocation of CRC/CCRC certification.

c. The penalty for failing to fulfill, in a satisfactory manner, a remedial requirement imposed by the Committee as a result of a sanction shall be automatic revocation unless the Committee determines that the remedial requirement should be modified based on good cause.

2. Notification of Sanctions –

a. The Certificant shall be given written notice within thirty days (30) of Committee decisions regarding complaints against him/her.

b. The complainant shall be given written notice of Committee decisions regarding his/her complaint after the time for appeal has expired.

c. If a sanction has been issued, counselor licensure, certification, or registry boards; other mental health licensure, certification, or registry boards; voluntary national certification boards; and appropriate professional associations shall also be notified of the results.

d. If a violation has been found and the Certificant’s CRC/CCRC certification has been suspended or revoked, a notice of the Committee action that includes the section(s) of the Code that were found to have been violated and the sanctions imposed shall be published in the CRCC newsletter.

Section F: Appeals

1. Basis of Appeals – Decisions of the Committee that a Certificant has violated the Code may be appealed by the Certificant found to have been in violation based on one or more of the following grounds:

a. The Committee violated its policies and procedures for processing complaints of ethical violations; and/or

b. The decision of the Committee was arbitrary and capricious and was not supported by the materials and testimony presented by the complainant and the Certificant.

2. Limitation of Appeals – After the Certificant has received notification that he/she has been found in violation of one or more sections of the Code, he/she shall be given thirty (30) days from the date such written notification is sent to notify the Committee in writing via certified mail that he/she is appealing the decision.

3. Form of Appeal – An appeal must be in writing stating one or more of the grounds of appeal listed in Subsection F.1(a) or (b) above, and the reasons for the appeal.

4. Appeals Panel – The CRCC Chair shall appoint a three (3) person appeals panel consisting of at least one (1) former Commission member, who is currently a CRC/CCRC, with the balance being CRC/CCRCs, none of whom served on the Committee at the time the original decision was rendered. The CRCC attorney shall serve as legal advisor and have the privilege of the floor.

5. Standard of Review – The three (3) member appeals panel shall be given copies of the materials available to the Committee when it made its decision, a copy of the hearing transcript if a hearing was held, a copy of the Committee’s decision and a copy of the letter filed by the appealing Certificant. The appeals panel shall not accept new evidence, but shall review the complaint only on the basis of the existing record.

6. Decision of Appeal – The decision of a majority of the members of the appeals panel shall be the final decision. The decision shall be rendered within a reasonable period of time. The decision of the appeals panel may include one of the following:

a. The decision of the Committee is upheld.

b. The decision of the Committee is reversed and/or remanded with guidance to the Committee for a new hearing. The reason for this action shall be given in detail to the Committee in writing.

When a Committee decision is reversed and/or remanded, the complainant and the Certificant shall be informed in writing and additional information may be requested. The Committee shall then render another decision after further hearing. A decision of the appeals panel to uphold the Committee decision is final.

Section G: New Evidence

In the event substantial new evidence, which was not available to the Certificant at the time of the hearing, is presented in a case where a final decision has been rendered, the Committee may reopen the case, if deemed appropriate by the Committee. The Committee shall consider substantial new evidence and, if it is found to be substantiated and capable of exonerating a Certificant originally found to have violated the Code, the Committee shall reopen the case and proceed with the entire complaint process again.

Section H: Legal Actions Relating to Ethics Complaints

1. All parties to a complaint are required to notify the Committee if they learn of any type of legal action (civil, criminal, or administrative) being filed in relation to the complaint.

2. In the event any type of legal action is filed regarding an accepted complaint, all actions related to the complaint may, at the discretion of the Committee, be stayed until the legal action has been concluded.

3. If actions to a complaint are stayed, the complainant and the Certificant shall be notified in writing.

4. When actions on a complaint are continued after a legal action is concluded, the complainant and the Certificant shall be notified in writing.

Section I: Records

1. The records of the Committee regarding complaints are confidential except as provided herein.

a. All information concerning complaints against Certificants shall be confidential except that the Committee may disclose such information when compelled by a validly issued subpoena or when otherwise required by law or valid court order.

b. Nothing in this Section shall be construed to prevent the Committee from communicating with the complainant, witnesses, potential members of fact-finding committees, or other sources of information necessary to enable the Committee to carry out its function, nor to prevent the notice of sanctions described in Subsection E.2 above.

2. Original copies of complaint records shall be maintained in files at CRCC’s administrative office or at an off-site location chosen by CRCC for a specified period of time as listed below:

a. Files of Sanctions or Letters of Instruction – In cases where the Committee has found an ethical violation and imposed any sanction or Letter of Instruction, a copy of the Committee’s decision shall be maintained indefinitely. A copy of the entire record on such matter shall be maintained for not less than five (5) years after the Committee closed the case.

b. Files for Non-Violations – Except for those cases closed for insufficient evidence, personally identifiable information concerning a Certificant who has been found not to have violated the Code shall be maintained for not less than one (1) years after the Committee has closed the case.

c. Files for Insufficient Information – In cases where the Committee has closed a case due to evidence insufficient to sustain a complaint of ethical violation, records containing personally identifiable information shall be maintained for not less than one (1) year after the Committee has closed the case.

d. Files After Death – All records containing personally identifiable information shall be destroyed one (1) year after the Commission is notified of the death of the Certificant.

e. Records for Education Purposes – Nothing in this Section shall preclude the Committee from maintaining records in a form that prevents identification of the Certificant so that it may be used for archival, educational, or other legitimate purposes.

3. Members of the Committee shall keep copies of complaint records confidential and shall destroy copies of their records relating to a complaint on the sooner of the date the time for appeal has expired or the date the member is no longer a member of the Committee.

CRCC Ethics Complaint Form

The Commission on Rehabilitation Counselor Certification (CRCC) supplies this form for individuals (complainants) who wish to submit a complaint against a rehabilitation counselor certified by CRCC. This complaint form is an official form and must be completed in its entirety, signed and submitted to the CRCC along with suitable documentation in support of this complaint. Submissions must be marked “Confidential” and mailed to: Ethics Committee, CRCC, 300 N. Martingale Road, Suite 460, Schaumburg, IL 60173. Because the complaint will be copied, do not highlight information within the complaint, do not staple pages, and do not mark pages with tabs of any sort.

The CRCC strongly encourages that you review the CRCC Code of Professional Ethics for Rehabilitation Counselors and the CRCC Guidelines and Procedures for Processing Complaints (a summary designed to assist you with the process) before and during the preparation of this CRCC Ethics Complaint Form. These documents are available on the CRCC website at www.crccertification.com. This review will assist you in understanding the organization’s procedures and ethical standards. You may also telephone the CRCC administrative offices at (847) 944-1325, weekdays between 8:30 a.m. and 4:30 p.m. Central Time with questions concerning this process, to obtain the aforementioned materials, or to request information in alternative format.

(Please Print Legibly or Type)

SECTION I

Your Name (hereinafter referred to as “Complainant”):

Address:

City: State/Province: Zip/Postal Code:

Phone Number: E-mail:

SECTION II

Name of Certified Individual (hereinafter referred to as “Certificant”):

Address:

City: State/Province: Zip/Postal Code:

SECTION III

If you are a client, you are encouraged to use the grievance process available at the agency or institution from which you are receiving services. Have you done so? Yes No N/A

If you are a professional colleague, you are encouraged to discuss this situation with the CRC you are filing a complaint against. Have you done so? Yes No N/A

Have you filed formal complaints with other organizations? n Yes No N/A

If yes to question above, please indicate below where else this complaint has been filed. If you check one or more items below, please attach existing documents and a description of the status of the complaint(s).]

State licensing board

State: ___________________________________ Date Filed: ___________________

National certification board

Organization: ____________________________________ Date Filed: ___________________

Professional organization

Organization: ____________________________________ Date Filed: ___________________

Civil law suit (e.g., malpractice)

Jurisdiction: ___________________________________ Date Filed: ___________________

Administrative appeal or grievance

Jurisdiction: ___________________________________ Date Filed: ___________________

University grievance committee

University: ___________________________________ Date Filed: ___________________

Other

Organization: ____________________________________ Date Filed: ___________________

SECTION IV

Cite specific Standard(s) alleged to have been violated:

SECTION V

Cite the nature of your complaint and specific dates and events. (Supplemental attachments must be signed
and dated.)

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

SECTION VI

Attach supporting documentation to substantiate the allegations. Failure to do so will result in a determination that the complaint has not been completed in its entirety. List the supporting documentation that is attached (i.e. invoices and payments, signed statements from physician(s) and other professional personnel, correspondence to and from certificant, etc.):

STATEMENT OF UNDERSTANDING/RELEASES:

1. By signing this form, I affirm that the allegations set forth in this complaint and any accompanying materials are based on my own personal knowledge and are true and correct to the best of my knowledge and belief. I further affirm that I have submitted any and all information and materials that I believe relate to the allegations set forth in the complaint currently available to me. I understand and agree that all information and materials provided by me in connection with this complaint may be used as evidence by the Ethics Committee and/or CRCC.

2. Further, by signing this form, I acknowledge that all information, including a copy of this complaint form, any accompanying letters of complaint and supporting documentation will be submitted to the Ethics Committee and the Respondent (in the event that the complaint is accepted for adjudication).

3. Further, by signing this form, I acknowledge that I must treat all information as confidential, and that CRCC will keep all information it receives strictly confidential, except if it discloses the information to its attorneys, the Respondent, or me, or is required by law, regulation or court order to disclose the information.

4. I further acknowledge that I have read the CRCC Code of Professional Ethics for Rehabilitation Counselors and the CRCC Guidelines and Procedures for Processing Complaints and understand the procedures that will be followed to process this complaint.

5. (Applicable only where this complaint is being filed by a current or former client of the Certificant and the complaint relates to the services provided to such client.) Further, by signing this form, I hereby grant permission to the Certificant to release all records of interactions between me and the Certificant to the Ethics Committee and to answer all questions the Ethics Committee may ask concerning those interactions. Thus, the entire contents of my file, including documents from other service providers, may become part of the evidence.

Signature of Complainant Date

RECOMMENDED CITATION

Commission on Rehabilitation Counselor Certification. (2006).
CRCC Guidelines and Procedures for Processing Complaints and Form.
Retrieved [date] from, http://www.crccertification.com/pages/30code.html