ALTERNATIVE DISPUTE RESOLUTION (‘ADR’) FORM

The form below must be completed in its entirety and submitted electronically or by post. Please note that we will not respond to ADR requests made for sites that are not registered with the eCOGRA ADR Service.

Personal Details Title
Full Name
City
Country
Contact Number
Email

Site Details Site
URL
e.g.: www.ecogra.org
Your Username
Date of Incident
Contact Email

Software Provider Information Did you inform software provider of dispute
If so, to whom

PLEASE NOTE: If your complaint does not relate to the outcome of a gambling transaction but rather a responsible gambling issue, this is deemed to be a regulatory issue by the GB Gambling Commission and should be submitted to them here.

Your dispute:

Security

Security code

By submitting this dispute, I verify the information provided is accurate and true and consent to eCOGRA having access to my personal information held by the GB Gambling Commission’s licence holder. I have read and agree to abide by the Policies and Procedures. I understand an accredited ADR mediator will within three weeks of receiving the dispute inform me, together with the reason, should eCOGRA decide to decline the dispute and make every effort to conclude the dispute resolution process within ninety days of receiving the dispute and all other relevant information.