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Athletic Trainers
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Ethics Complaint Form
Please complete the following questionnaire to the best of your ability. (
PDF Version
)
Name of Athletic Trainer:
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Title:
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Employer:
*
Phone No.:
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Address:
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City:
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State:
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Zip Code:
*
1. Please identify the section of the NATA Code of Ethics that you feel has been violated.:
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2. Please provide a detailed factual scenario setting forth all relevant facts in support of your assertion of a violation or violations.:
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3. Please provide the name(s) and contact information (phone # preferred) of any and all witnesses to the alleged violation or violations.:
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4. Please provide a list of all documentation (and all copies of those documents) supporting your assertion of said violation or violations.:
*
COMPLAINING INDIVIDUAL:
*
Date:
*
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