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O-7, r. 16 - Regulation respecting the conciliation and arbitration procedure for the accounts of members of the Ordre des optométristes du Québec
Schedule
Disposition versions
SCHEDULE I
(s. 8)
APPLICATION FOR ARBITRATION OF AN ACCOUNT
I, the undersigned, __________(client’s name)__________ __________(domicile)__________ declare that:
(1) __________(member’s name)__________ is claiming from me (or refuses to reimburse to me) a sum of money for professional services.
(2) I have enclosed a copy of the conciliation report.
(3) I am applying for arbitration of the account under the Regulation respecting the conciliation and arbitration procedure for the accounts of members of the Ordre des optométristes du Québec (chapter O-7, r. 16).
(4) I have received a copy of the Regulation mentioned above and have taken cognizance thereof.
(5) I agree to submit to the procedure provided for in the Regulation and, where required, to pay to __________(member’s name)__________ the amount of the arbitration award.
_____________________________________________
(signature)
