Patient Complaints

If you haven't already, please review the doctor-patient mediation page prior to completing the complaint form below. 

Please Note

  • Complaints regarding billing issues/disputes do not qualify and will not receive a response.
  • The Washington State Dental Association can only accept complaints against dentists who are members of our organization. If a dentist is a non-member, we will direct you to contact the Washington State Department of Health.
  • Cases that are in litigation are not accepted.

Patient Information

Please provide the following information about yourself.
Please note: If your complaint qualifies for Peer Review, we will follow up with you at the email address provided.

Dentist Information

Please provide the following information about the dentist against whom you seek to file a complaint.

Complaint

WSDA cannot accept complaints regarding billing issues, nor can we accept complaints against dentists who are not members of WSDA.

Additional Information

Please provide the following additional information so that we can best understand your complaint.
Have you discussed your concern with the dentist?

Did the dentist respond?

Have you been examined or treated by another dentist for this problem?

Have you asked for assistance in settling your concern from another source?

Has a lawsuit been filed involving this case?

Have you filed a complaint with the state board?




ADA
"State":"WA"