Concern about a dental professional

Please use this form to make a complaint against a dental professional.
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Your details (Section 1 of 6)

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Title*

First name*

Last name*

Date of birth*

NOTE: Please ensure your date of birth has been selected correctly, as it may be used to obtain information about the issue you are reporting to us, including dental records.

Email address*

Home number

Mobile number*

Postcode search*

Start typing to search for your address

Address Line 1

Address line 2

Address line 3

City/Town

County/State

Postcode

Country

Please tell us who you are*

Do you consider yourself to be a whistleblower? Please review the UK government guidance on whistleblowing before providing your response, as legal protection may apply.*

Yes

Please explain why you think you are a whistleblower and please confirm the concern you are raising counts as whistleblowing:*

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On behalf of someone else (Section 2 of 6)

Please provide the details of the person you are making this complaint on behalf of.

Are you making this complaint on behalf of someone else?

Yes

Please be advised that the GDC requires the appropriate permissions to share information with you as their representative; and we may need to contact you (and the patient) to seek further information before we can proceed.

If you are raising concerns relating to a child patient the GDC requires their parent or guardian’s consent
If you are raising concerns relating to an adult dependant or an individual for whom you have power of attorney, you will need to provide us with proof of your ability to consent on their behalf.

Please see our privacy notice: www.gdc-uk.org/privacy for more information. You can also raise any concerns on submission of this form to us.

Title*

First name*

Last name*

Date of birth*

Email address

Home number

Mobile number

Same as my address

Postcode search*

Start typing to search for your address

Address line 1

Address line 2

Address line 3

City/Town

County/State

Postcode

Country

What is your relationship to this person?*

Why is that person not making this complaint?*

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* Patient permission

Yes

Select 'Yes' if the person you are complaining on behalf of has given you permission to do so.

Reason for not giving permission*

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Who should the GDC contact?*

You

The person you are complaining on behalf of

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About the dentist or dental professional (Section 3 of 6)

Please give us details about the dental professional you are complaining about. Our enquires are based on the information you give us so it is important that it is as full and accurate as possible.

Every dental professional registered with the GDC has a unique GDC registration number that we can use to identify them. The registration number will be between three and six digits.

You can ask the dental professional for their GDC registration number or you can search our online dental professionals register here.

If you do not know their registration number or full name you may find it helpful to speak to the dental practice or check their website. Please provide as many details about the dental professional as you can.

Name of the dental professional*

GDC registration number

Dental practice name

Postcode search

Start typing to search for the dental practice address

Address line 1

Address line 2

Address line 3

City/Town

County/State

Postcode

Country

Have you made a complaint to the dental professional or the dental practice?*

Yes

Additional information

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About the information you hold (Section 4 of 6)

The GDC needs to meet data protection and confidentiality obligations so that we carry out our regulatory work in a way that is safe and maintains the trust of the public.

Part of meeting those obligations is to make sure we have a lawful basis for using any information we request or receive, We must also follow the correct procedure when seeking disclosure and permission to use sensitive or restricted material.

What information should you not send?

Some types of information and documents require special permission before they can be disclosed or used, so shouldn’t be sent with this form.

Please do not send any of the following to us:

Any documents directly connected with ongoing legal proceedings in the Criminal and/or Civil Courts and tribunals unless they are already generally available to the public or accompanied by permission from the Courts. Examples of these include sealed documents, copies of Court judgments, statements and Court transcripts.
Any documents related to proceedings in the Family Court, unless the Court has directed for that specific document to be disclosed
Sensitive information from sources which may attract enhanced privacy provisions. This includes Local Authority social care material, information concerning those without capacity and information about children.
Any documents where the nature of the material suggests it may be confidential. This includes private legal communications between lawyers and their clients and material marked as private or confidential.

It’s important to understand that in some circumstances disclosure and use of such information might result in a contempt of court investigation and/or other legal proceedings against you and the GDC.

What if you are unsure what to send?

If you are unsure about any information you hold, please don’t send it to us.

If you feel the information is relevant to your complaint, please list or describe it and we will consider whether to request copies from you.

There will also be an opportunity to discuss what information is relevant to your complaint if an investigation is opened.

If information of this nature does exist and is relevant to your complaint, then we will consider making appropriate legal applications for the disclosure and use of the information.

Please confirm:

I have read the information above and I will not provide information that is subject to privacy restriction (such as that described above) to the GDC with this form*

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Your complaint (Section 5 of 6)

Please provide as much information as you can in this section, including the uploading of suppporting documentation. This may assist us in being able to deal with your complaint more quickly.

Is your complaint about NHS treatment or private treatment?*

NHS

Private

Both

I don't know

NOTE: To check if your complaint is about NHS treatment, click here

What type of treatment did you receive?*

My concern is about*

When did the incident occur?*

NOTE: If there are multiple incidents, please mention the dates in the box below when describing the incidents.

Describe the incident(s) you want to make a complaint about and what happened?*

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NOTE: Please click here to see what the GDC cannot help with.

Have you received any further treatment, or have you been seen by anyone else?*

Yes

Would you like to upload further evidence in support of your complaint?

Yes

For example:

Receipts of payment for treatment
Copies of treatment plans and/or NHS FP17 form
Copies of your complaint letters to the dentist / dental practice and any responses you have received
Photographs or images relevant to the concerns you have raised

NOTE: After you have submitted your complaint, you will be directed to upload your documents for us to access. Uploading your documents may assist to deal with your complaint quicker.

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Personal data and declaration (Section 6 of 6)

Why does the GDC use your personal data?

The GDC will process your personal data in order to carry out its statutory function as a healthcare regulator. This includes transferring your concern(s) to other regulators or bodies where it falls within their remit or they are better placed to deal with it, such as NHS, CQC. We will need to use and share some or all of the information you give us for that purpose. You can read more about this and your rights under data protection legislation in our privacy notice.

How will your information be used and shared?

To be able to consider your concerns we may need to give details about them to:

The dentist or dental professional you are making a complaint about.
Their employer(s).
Their legal representative(s).
Other public bodies e.g. NHS, CQC.

We may also need to share details of your concerns with other relevant individuals or organisations in order to carry out our enquiries.

The details we may need to share include your name, address and details of what you are making a complaint about. Initially, as far as possible, it will not include your contact details such as your phone number or email address.

In the event that we make further enquiries on the information you have provided, we may need to request further details from you. To help with our investigation, we may also need to obtain information, such as records from any previous or subsequent treating dentists, other clinicians, individuals or organisations.

Please note that information (including contact details and health records or other sensitive information) that the GDC receives during its enquiries:

may be shared with the dental professional and their employer
may be shared with our legal representatives, clinical advisors, experts, case examiners and investigating and practice committees as required
may be discussed with the dental professional, and/or their indemnity provider, legal representatives, and clinical advisors or experts, for the purpose of responding to any allegations that are raised against them, and
may, where it is in the public interest to do so, be disclosed by the GDC to other individuals or organisations.

Please note that information (including contact details and health information) may, where it is in the public interest to do so, be disclosed by the GDC to other regulators or bodies (e.g. NHS, CQC etc.), where a concern falls within their remit or they are better placed to deal with it. Information about other regulators or bodies we work with is on our website.

Sharing information you provide*

I have no concerns about the information provided being shared.

There is information provided that I have concerns about being shared.

Please tell us about the information you have concerns about and why. We will consider the information you provide when deciding how to manage the case.*

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Record Request*

If my concerns relate to treatment, I understand that the GDC will require my dental records in order to carry out its statutory function as a healthcare regulator. I ask that, if requested, these records are provided to the GDC for this purpose.

Name*

Date of Birth*

Declaration*

I declare that the information I have given in this form is to the best of my knowledge complete and accurate.

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