Professional Conduct Review Form

Please note, by completing and submitting this form, you are allowing the Aging Life Care Professional (Care Manager) in question to disclose information about the case in which you are filing a complaint.

The purpose of this process is to promote professional behavior by ALCA members. The ALCA Professional Review Process is not a dispute resolution mechanism, nor a means to pursue legal or financial remedies. Fee and similar contract disputes involving consumers are generally outside the scope of this process. We recommend that persons with such concerns discuss them directly with the Aging Life Care Professional. If the outcome is unsatisfactory, other options include a local Better Business Bureau, formal Alternative Dispute Resolution organizations or a professional licensing body.

Complainant Contact Information
 
 
 
 
 
 
 
 
 
 
Aging Life Care Professional's Contact Information (Care Manager)
 
 
 
 
 
 
 
 
 
Details regarding the complaint
 
 
 
 
 
 
 
Upload Documents
  • Allowed file formats are: doc;docx;pdf
  • The maximum file size allowed is 4 MB