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https://www.doh.wa.gov/LicensesPermitsandCertificates/FileComplaintAboutProviderorFacility/ComplaintForms
Forms to file a complaint against a health care provider or facility. This includes forms in the Spanish language, and the complaint form for the Nursing and Medical Commission professions.
https://www.health.ny.gov/forms/doh-3867.pdf
DOH-3867 (2/20) p 4 of 4 – Instructions INSTRUCTIONS FOR COMPLETING COMPLAINT FORM To file a complaint about a physician (M.D. or D.O.), Physician Assistant or Specialist Assistant licensed to practice medicine by the State of New York, please complete this form and mail the original to: NYS Department of Health Office of Professional Medical Conduct
https://dchealth.dc.gov/service/file-complaint-health%20prof
Review the ways to file a complaint against a DC health professional, including submission of a printable PDF form to the Licensing Board that regulates the profession. File a Complaint Against a Health Professional or Facility doh
https://doh.sd.gov/providers/licensure/complaints.aspx
Email: DOH OLC Complaint Describe the incident and give the facility name or nurse aide name, the patient name, and the date and time of the incident. Then, submit your complaint in writing to ensure we understand the issue correctly.
https://www.doh.wa.gov/LicensesPermitsandCertificates/FileComplaintAboutProviderorFacility/HealthProfessionsComplaintProcess
Send your complaint through online storage services (Dropbox, Google Drive, etc.) Send using a secure email service that require login credentials. Send pictures of your filled out complaint form. Often pictures of complaint forms are not formatted correctly and can be difficult to read. Please type your complaints as an email message.
http://www.floridahealth.gov/licensing-and-regulation/enforcement/admin-complaint-process/index.html
The Florida Department of Health works to protect, promote & improve the health of all people in Florida through integrated state, county & community efforts. 850 …
https://www.doh.wa.gov/AboutUs/Fileacomplaint
Medicare beneficiary complaints about the quality or necessity of the care from a healthcare provider or facility, file a complaint.
https://www.state.nj.us/health/healthfacilities/file_complaint.shtml
Complaint Hotline: 1-800-792-9770 The 24-hour hotline handles consumer complaints and facility emergencies seven days a week. Patients, health care facility employees and other members of the public may file complaints about hospitals, ambulatory …
https://www.health.ny.gov/forms/
New York State Department of Health Forms. skip to main content. Navigation menu. Department of Health. Individuals/Families. Birth, Death, Marriage & Divorce Records ... Complaint Form; Return to beginning of index. Immunization. Influenza Vaccine (DOH–4482) (PDF) Infection Control.
https://www.health.ny.gov/professionals/doctors/conduct/file_a_complaint.htm
Complaint Form (PDF) Instructions for completing the complaint form. Arabic (PDF) Chinese (PDF) Haitian (PDF) Polish (PDF) Russian (PDF) Spanish (PDF) Italian (PDF) Korean (PDF) How to Choose the Right Physician - How to Tell Us if You Don't. Fraud in Medicine.
https://www.flhealthcomplaint.gov/
Florida Department of Health Division of Medical Quality Assurance Web Portal Division of Medical Quality Assurance Web Portal
https://healthapps.state.nj.us/forms/index.aspx
The forms are now ONLY available for download on the EDRS System. REG-38A: Application for Genealogical Certification or Certified Copy of a Vital Record for Local Use (fillable PDF, English, with instructions) (Updated October 5, 2017) NEW FORM! Instructions for Local Registrars pdf 105k The forms are now ONLY available for download on the ...
https://apps.health.ny.gov/nursing_homes/complaint_form/complain.action
Nursing Home Complaint Form. Instructions. The New York State Department of Health, Division of Nursing Home and ICF/IID Surveillance is responsible for investigating complaints about resident abuse, neglect, mistreatment and incidents occurring in nursing homes in New York State that are related to a State and/or Federal regulatory violation.
https://www.dos.pa.gov/ProfessionalLicensing/FileaComplaint/Pages/default.aspx
You may request a Statement of Complaint Form by mail, by calling the Professional Compliance Office Hotline at 1-800-822-2113 (if you are calling from within Pennsylvania) or at 1-717-783-4854 (if you are calling from outside Pennsylvania).
https://apps.health.ny.gov/surveyd8/email-hospdtc
Before filing a complaint, concern or inquiry, please first review and select from the subject drop-down list to see if your question or concern can be directed to other offices within the Department of Health or to another State agency. If you have multiple questions which relate to …
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