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Complaints Form IMPORTANT: Please do not complete this form until you have fully read the Code of Professional Conduct. Date of Complaint: Your Details: Name: Address: Telephone Number: Email Address: Details of Member about whom a complaint is being made: Name: Address: Telephone Number: Email Address: Has this matter been reported to relevant statutory authorities or are legal proceedings pending? Date of purported breach of Code of Professional Conduct: Please state below those paragraphs of the Code of Professional Conduct you allege to have been contravened. Please include ALL issues you would like CIEEM to consider as the complaint cannot be reopened on new issues arising from the same case. Paragraphs alleged to have been breached Supporting Statement – please state briefly (using bullet points) the facts of your case referencing each bullet point directly to the specific statements in the documents you are providing. Do you have any further comments? You must provide referenced evidence in support of your allegation, which should be submitted electronically. I understand a copy of this form will be sent to the Member alleged to have contravened the Code of Professional Conduct. Signed: Date: Please submit this form and supporting documents/evidence electronically to [email protected] or on a CD to: Sally Hayns CEcol MCIEEM Chief Executive Chartered Institute of Ecology and Environmental Management 43 Southgate Street Winchester Hampshire SO23 9EH