By submitting the below form, I hereby authorize AAG to contact me regarding this complaint, if deemed necessary. I authorize AAG to release this complaint and all other supporting material I have provided or may provide in the future to the subject of the complaint, members of AAG’s Standing Committee on Disciplinary and Eligibility Matters for AAG Members, the AAG Council, AAG’s attorneys and others as deemed appropriate by AAG or as required by law.

(NOTE: It is advisable for anyone submitting a complaint or allegation to keep notes on the names of potential witnesses. To the extent practical, the complainant should provide details, specific facts and documentation of the allegations. Additionally, the complainant should provide their contact information, including a phone number and email address.)