{"id":6097,"date":"2022-01-20T00:25:13","date_gmt":"2022-01-20T00:25:13","guid":{"rendered":"https:\/\/cpatacabamcdev.wpengine.com\/?page_id=6097"},"modified":"2024-06-11T22:34:26","modified_gmt":"2024-06-11T22:34:26","slug":"agent-conduct-inquiry-complaint-form","status":"publish","type":"page","link":"https:\/\/cpata-cabamc.ca\/en\/public-resources\/agent-conduct-inquiry-complaint-form\/","title":{"rendered":"Submit an Inquiry or Complaint"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"6097\" class=\"elementor elementor-6097\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-cef2296 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"cef2296\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-c060b5d\" data-id=\"c060b5d\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3e357ee uael-gf-check-yes uael-gf-ajax-true uael-gf-style-box uael-gf-input-size-sm uael-gf-enable-classes-no uael-gf-check-default-no uael-gf-button-left uael-gf-btn-size-sm elementor-widget elementor-widget-uael-gf-styler\" data-id=\"3e357ee\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"uael-gf-styler.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"uael-gf-style uael-gf-check-style elementor-clickable\">\n\t<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_8' style='display:none'><form method='post' enctype='multipart\/form-data'  id='gform_8'  action='\/en\/wp-json\/wp\/v2\/pages\/6097' data-formid='8' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_8' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_8_48\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_48'>Facebook<\/label><div class='ginput_container'><input name='input_48' id='input_8_48' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_8_48'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_8_32\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Personal Info<\/h3><\/div><fieldset id=\"field_8_1\" class=\"gfield gfield--type-name field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_8_1'>\n                            \n                            <span id='input_8_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_8_1_3' value='' tabindex='2'  aria-required='false'     \/>\n                                                    <label for='input_8_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_8_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_8_1_6' value='' tabindex='4'  aria-required='false'     \/>\n                                                    <label for='input_8_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_8_5\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_5'>Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_5' id='input_8_5' type='text' value='04\/05\/2026' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon' tabindex='6'  placeholder='mm\/dd\/yyyy' aria-describedby=\"input_8_5_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_8_5_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_8_5' class='gform_hidden' value='https:\/\/cpata-cabamc.ca\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_8_23\" class=\"gfield gfield--type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_23'>Licensee Time Zone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_23' id='input_8_23' class='large gfield_select' tabindex='7'   aria-required=\"true\" aria-invalid=\"false\" ><option value='Newfoundland (GMT - 3:30)' >Newfoundland (GMT - 3:30)<\/option><option value='Atlantic (GMT - 4)' >Atlantic (GMT - 4)<\/option><option value='Eastern (GMT - 5)' >Eastern (GMT - 5)<\/option><option value='Central (GMT - 6)' >Central (GMT - 6)<\/option><option value='Mountain (GMT - 7)' >Mountain (GMT - 7)<\/option><option value='Pacific (GMT - 8)' >Pacific (GMT - 8)<\/option><\/select><\/div><\/div><fieldset id=\"field_8_24\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Honorifics<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_8_24'><div class='gchoice gchoice_8_24_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.1' type='checkbox'  value='Mr.'  id='choice_8_24_1' tabindex='8'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_24_1' id='label_8_24_1' class='gform-field-label gform-field-label--type-inline'>Mr.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_24_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.2' type='checkbox'  value='Mrs.'  id='choice_8_24_2' tabindex='9'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_24_2' id='label_8_24_2' class='gform-field-label gform-field-label--type-inline'>Mrs.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_24_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.3' type='checkbox'  value='Ms.'  id='choice_8_24_3' tabindex='10'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_24_3' id='label_8_24_3' class='gform-field-label gform-field-label--type-inline'>Ms.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_24_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.4' type='checkbox'  value='Dr.'  id='choice_8_24_4' tabindex='11'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_24_4' id='label_8_24_4' class='gform-field-label gform-field-label--type-inline'>Dr.<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_24_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.5' type='checkbox'  value='First name only'  id='choice_8_24_5' tabindex='12'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_24_5' id='label_8_24_5' class='gform-field-label gform-field-label--type-inline'>First name only<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_24_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.6' type='checkbox'  value='Other'  id='choice_8_24_6' tabindex='13'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_24_6' id='label_8_24_6' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_8_25\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_25'>Other<\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_8_25' type='text' value='' class='large'   tabindex='14'   aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_8_8\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Pronouns<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_8_8'><div class='gchoice gchoice_8_8_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.1' type='checkbox'  value='He \/ Him'  id='choice_8_8_1' tabindex='15'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_8_1' id='label_8_8_1' class='gform-field-label gform-field-label--type-inline'>He \/ Him<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_8_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.2' type='checkbox'  value='She \/ Her'  id='choice_8_8_2' tabindex='16'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_8_2' id='label_8_8_2' class='gform-field-label gform-field-label--type-inline'>She \/ Her<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_8_8_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_8.3' type='checkbox'  value='They \/ Their'  id='choice_8_8_3' tabindex='17'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_8_3' id='label_8_8_3' class='gform-field-label gform-field-label--type-inline'>They \/ Their<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_8_10\" class=\"gfield gfield--type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_10'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_10' id='input_8_10' type='email' value='' class='large' tabindex='18'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_8_11\" class=\"gfield gfield--type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_11'>Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_11' id='input_8_11' type='tel' value='' class='large' tabindex='19'   aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_8_12\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Preferred method of contact<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_12'>\n\t\t\t<div class='gchoice gchoice_8_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Email'  id='choice_8_12_0' onchange='gformToggleRadioOther( this )'  tabindex='20'  \/>\n\t\t\t\t\t<label for='choice_8_12_0' id='label_8_12_0' class='gform-field-label gform-field-label--type-inline'>Email<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Phone'  id='choice_8_12_1' onchange='gformToggleRadioOther( this )'  tabindex='21'  \/>\n\t\t\t\t\t<label for='choice_8_12_1' id='label_8_12_1' class='gform-field-label gform-field-label--type-inline'>Phone<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_8_21\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you have any accessibility considerations that we should be mindful of when communicating with you?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_21'>\n\t\t\t<div class='gchoice gchoice_8_21_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Yes'  id='choice_8_21_0' onchange='gformToggleRadioOther( this )'  tabindex='22'  \/>\n\t\t\t\t\t<label for='choice_8_21_0' id='label_8_21_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_21_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='No'  id='choice_8_21_1' onchange='gformToggleRadioOther( this )'  tabindex='23'  \/>\n\t\t\t\t\t<label for='choice_8_21_1' id='label_8_21_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_8_13\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_13'>Please specify<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_13' id='input_8_13' class='textarea small' tabindex='24'     aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_8_33\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Inquiry &amp; Complaints<\/h3><\/div><fieldset id=\"field_8_26\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you have:<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_26'>\n\t\t\t<div class='gchoice gchoice_8_26_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='have a &lt;b&gt;general question&lt;\/b&gt; about an agent\u2019s obligations?'  id='choice_8_26_0' onchange='gformToggleRadioOther( this )'  tabindex='25'  \/>\n\t\t\t\t\t<label for='choice_8_26_0' id='label_8_26_0' class='gform-field-label gform-field-label--type-inline'>have a <b>general question<\/b> about an agent\u2019s obligations?<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_26_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='concerns with a specific agent or agents and want to discuss your concerns and\/or seek possible &lt;b&gt;informal resolution? &lt;\/b&gt;'  id='choice_8_26_1' onchange='gformToggleRadioOther( this )'  tabindex='26'  \/>\n\t\t\t\t\t<label for='choice_8_26_1' id='label_8_26_1' class='gform-field-label gform-field-label--type-inline'>concerns with a specific agent or agents and want to discuss your concerns and\/or seek possible <b>informal resolution? <\/b><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_26_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='concerns with a specific agent or agents and wish to file a &lt;b&gt;formal complaint?&lt;\/b&gt;'  id='choice_8_26_2' onchange='gformToggleRadioOther( this )'  tabindex='27'  \/>\n\t\t\t\t\t<label for='choice_8_26_2' id='label_8_26_2' class='gform-field-label gform-field-label--type-inline'>concerns with a specific agent or agents and wish to file a <b>formal complaint?<\/b><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_26_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_26' type='radio' value='concerns about a &lt;b&gt;potential fraud&lt;\/b&gt; or a non-agent engaging in &lt;b&gt;unauthorized practice&lt;b&gt;?'  id='choice_8_26_3' onchange='gformToggleRadioOther( this )'  tabindex='28'  \/>\n\t\t\t\t\t<label for='choice_8_26_3' id='label_8_26_3' class='gform-field-label gform-field-label--type-inline'>concerns about a <b>potential fraud<\/b> or a non-agent engaging in <b>unauthorized practice<b>?<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_8_43\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h4><u>Concerns<\/u><\/h4><\/div><div id=\"field_8_47\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p><i><b>You may notify CPATA at any time if you wish for this form to instead be considered a formal complaint.<\/b><\/i><\/p><\/div><fieldset id=\"field_8_30\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you wish to name the agent?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_30'>\n\t\t\t<div class='gchoice gchoice_8_30_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='Yes'  id='choice_8_30_0' onchange='gformToggleRadioOther( this )'  tabindex='29'  \/>\n\t\t\t\t\t<label for='choice_8_30_0' id='label_8_30_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_30_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_30' type='radio' value='No'  id='choice_8_30_1' onchange='gformToggleRadioOther( this )'  tabindex='30'  \/>\n\t\t\t\t\t<label for='choice_8_30_1' id='label_8_30_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_8_39\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there more than 1 agent?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_39'>\n\t\t\t<div class='gchoice gchoice_8_39_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='Yes'  id='choice_8_39_0' onchange='gformToggleRadioOther( this )'  tabindex='31'  \/>\n\t\t\t\t\t<label for='choice_8_39_0' id='label_8_39_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_39_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='No'  id='choice_8_39_1' onchange='gformToggleRadioOther( this )'  tabindex='32'  \/>\n\t\t\t\t\t<label for='choice_8_39_1' id='label_8_39_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_8_27\" class=\"gfield gfield--type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name of Agent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name no_last_name no_suffix gf_name_has_1 ginput_container_name gform-grid-row' id='input_8_27'>\n                            \n                            <span id='input_8_27_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_27.3' id='input_8_27_3' value='' tabindex='34'  aria-required='true'     \/>\n                                                    <label for='input_8_27_3' class='gform-field-label gform-field-label--type-sub '>Full Name<\/label>\n                                                <\/span>\n                            \n                            \n                            \n                        <\/div><\/fieldset><div id=\"field_8_29\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_29'>Agent(s) Name<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_29' id='input_8_29' class='textarea medium' tabindex='38'   placeholder='Agents names'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_8_31\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you consent to CPATA contacting the Agent to attempt resolution?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_31'>\n\t\t\t<div class='gchoice gchoice_8_31_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='Yes'  id='choice_8_31_0' onchange='gformToggleRadioOther( this )'  tabindex='39'  \/>\n\t\t\t\t\t<label for='choice_8_31_0' id='label_8_31_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_31_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_31' type='radio' value='No'  id='choice_8_31_1' onchange='gformToggleRadioOther( this )'  tabindex='40'  \/>\n\t\t\t\t\t<label for='choice_8_31_1' id='label_8_31_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_8_44\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h4><u>Complaints<\/u><\/h4><\/div><div id=\"field_8_46\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p><b><i>By filing this form as a formal complaint, you understand that this form will be shared with the Agent(s) and that the College cannot assist with an informal resolution (if you wish the College to assist in that way, please instead choose the option above). You understand that filing a formal complaint means this complaint will be referred to the Investigations Committee.<\/i><\/b><\/p><\/div><fieldset id=\"field_8_28\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is there more than one agent?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_8_28'>\n\t\t\t<div class='gchoice gchoice_8_28_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='Yes'  id='choice_8_28_0' onchange='gformToggleRadioOther( this )'  tabindex='41'  \/>\n\t\t\t\t\t<label for='choice_8_28_0' id='label_8_28_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_8_28_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_28' type='radio' value='No'  id='choice_8_28_1' onchange='gformToggleRadioOther( this )'  tabindex='42'  \/>\n\t\t\t\t\t<label for='choice_8_28_1' id='label_8_28_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_8_38\" class=\"gfield gfield--type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name of agent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name no_last_name no_suffix gf_name_has_1 ginput_container_name gform-grid-row' id='input_8_38'>\n                            \n                            <span id='input_8_38_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_38.3' id='input_8_38_3' value='' tabindex='44'  aria-required='true'     \/>\n                                                    <label for='input_8_38_3' class='gform-field-label gform-field-label--type-sub '>Full Name<\/label>\n                                                <\/span>\n                            \n                            \n                            \n                        <\/div><\/fieldset><div id=\"field_8_40\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_40'>Agent(s) Name<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_40' id='input_8_40' class='textarea medium' tabindex='48'   placeholder='Agents names'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_8_45\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h4><u>Inquiry<\/u><\/h4><\/div><div id=\"field_8_42\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_42'>What are your concerns \/ What question do you have for us?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_42' id='input_8_42' class='textarea large' tabindex='49'     aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_8_34\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Consent &amp; Verification<\/h3><\/div><fieldset id=\"field_8_15\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Summary may be shared<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_8_15'><div class='gchoice gchoice_8_15_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_15.1' type='checkbox'  value='I understand that CPATA may create a de-identified\/anonymized summary of my inquiry for educational purposes or to consider possible amendments to the Code of Professional Conduct, Regulations, By-Laws and\/or CPATA Policies.'  id='choice_8_15_1' tabindex='50'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_8_15_1' id='label_8_15_1' class='gform-field-label gform-field-label--type-inline'>I understand that CPATA may create a de-identified\/anonymized summary of my inquiry for educational purposes or to consider possible amendments to the Code of Professional Conduct, Regulations, By-Laws and\/or CPATA Policies.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_8_22\" class=\"gfield gfield--type-captcha gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_8_22'>CAPTCHA<\/label><div id='input_8_22' class='ginput_container ginput_recaptcha' data-sitekey='6LfeEnMpAAAAAITXIiIN7r052BnELYr16YfmSdu5'  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