Post Office Complaint Form

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NORTH CAROLINA BOARD OF ATHLETIC TRAINER EXAMINERS
POST OFFICE BOX 10769
RALEIGH, NORTH CAROLINA 27605
919-821-4980
919-833-5743 (FAX)
COMPLAINT FORM
Your Name: ____________________________________________________________
Your Address: __________________________________________________________
Your City: ________________________ State: _____________ ZIP: ______________
Your email: _____________________________________________________________
Home Telephone: ________________________ Work Telephone: ________________
Name of Person Against Whom Complaint is Filed: ___________________________
His/Her Work Location: __________________________________________________
His/Her Address: ________________________________________________________
His/Her City: ______________________ State: _______________ ZIP: ___________
His/her email (if known): __________________________________________________
His Her Home Phone: ____________________ Work Phone: ____________________
NATURE OF COMPLAINT
This should be explained in detail.
For example if a person is alleged to be
practicing without a license, specific examples must be cited and/or attached (i.e.:
newspaper articles, yearbooks, business cards, etc.). If known, his/her supervisor’s
name should be included. Please feel free to use additional sheets if necessary.
Please understand that the Board appreciates your help and we will not be back in
contact with you unless additional information is needed.

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