Report an Incident - Step 1 of 2

Members must report to PLP any situation that may give rise to a patient claim, i.e. a demand for money or services.

Even if a patient is not upset or angry, any member contemplating a refund of fees should contact PLP to receive guidance on the documentation required to protect the member’s interests. Failure to do so may jeopardize the member’s protection if the patient later demands more money from or commences a legal action against the member.

In some cases, the report will be recorded and the member will receive a form letter advising of the file number and to contact PLP in case of further developments. This would occur, for example, if you are reporting the matter only to protect your rights in case the patient makes a claim or demand in the future (called a “Precautionary Report”). If the matter requires immediate action, an Advisor will contact the member to obtain further information and provide assistance and advice.

Member Information

RCDSO #

First Name

Middle Name Optional

Last Name

Preferred Contact Information

How would you like us to contact you?

Phone Number

Alternate Phone Number Optional

Mailing Address

Country

Street Address

Suite, Apt, Unit Optional

City

Province

Postal Code

Your Role in the Incident

Practice Owner

Associate

Referring Dentist

Other