1. Please write LEGIBLY or TYPE all information.
2. Complete the top of the form in detail.
3. Write a description of complaint in space provided. Any additional
information that will not fit in the space provided may be stapled to
this form.
4. Sign your name in the space marked "Person Filing Complaint". You
should sign in front of a notary AND a witness.
5. Have the witness sign in front of the notary.
6. Have the Notary sign, seal and state expiration of his/her
commission.
7. Return Form to:
Oklahoma Board of Chiropractic Examiners
201 N.E. 38th Terrace, Suite 3
Oklahoma City, Oklahoma 73105
If you have any questions or comments about this form and its
completion please call the Oklahoma Chiropractic Board's office at
(405) 524-6223.
201 N.E. 38th Terrace · Suite 3 · Oklahoma City
· Oklahoma 73105 ·
405-524-OBCE (6223) · Fax: 405-524-9542
