File a Complaint

The filing of a complaint is for practice issues only. If you are experiencing problems applying for, or renewing a license you should review the instructional help documents on the particular board’s website responsible for issuing that license. Only after reviewing this material should the board be contacted for assistance. We take complaints very seriously and will review the details provided thoroughly to determine the appropriate level of action to be taken.

Your Information

To file a complaint, select the appropriate Board from the dropdown list. Then, provide the necessary contact information for each field. Each field noted by (*) is a required field.

Board

First Name

Middle Name

Last Name

Main Phone

Alternate Phone

Street Address Line 1

Street Address Line 2

City

State

Zip Code

County

Patient Name

Patient's Date of Birth

Who is the complaint against?

To register a complaint, provide the complete contact information for whom you are filing the complaint against.

Complaint Against

First Name

Middle Name

Last Name

License Type

License Number

Phone Number

Alternate Phone Number

Email Address

Street Address Line 1

Street Address Line 2

City

State

Zip Code

County

Tell us what happened.

In order for your complaint to be processed effectively, it is very important that you provide as much detail as possible about what happened. You may also attach any necessary documents associated with your complaint by clicking the 'Add Supporting Documents' button.

Description

Supporting Documents?

When did it happen?

Please provide an end date in order to submit your complaint.

Start Date

End Date

Where did it take place?

Provide the address information for where it took place.

Name of Business at the Adddress

Street Address Line 1

Street Address Line 2

City

State

Zip Code

County

Cancel

File a Complaint

Your Information

Who is the complaint against?

Tell us what happened.

When did it happen?

Where did it take place?

Your Complaint has been submitted