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Complaint Form
NAME:
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DATE:
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+
Email address
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Are you a Board certified Pharmacist?
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Yes
No
Pharmacy Specialty
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N/A
Ambulatory Care
Cardiology
Critical Care
Geriatric
Infectious Disease
Nuclear
Nutrition Support
Oncology
Pediatrics
Pharmacotherapy
Psychiatric
Solid Organ Transplant
Eligibility ID (test takers if applicable)
Exam ID (test takers if applicable)
Complaint Category
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Scheduling or Displacement Issue
CE Provider Issue
Exam Content Relevance/Clarity
Exam Time Allotment
Testing Center Issue
Application Process
Certificates (not received, damaged, name issue)
General issue
Misuse of the BPS Marks/Logos
Certification Policy Issue
Recertification Policy Issue
Report Unauthorized Use of BPS credential
Website Issue (access, ease of use, content)
Please provide detailed description of the complaint
*
Supporting Documentation as applicable