The Division of Medical Quality Assurance (MQA), Consumer Services Unit (CSU) announces a revised Health Care Provider Complaint Form!
The CSU investigates complaints and reports involving licensed and unlicensed health care providers. The form may be completed electronically by typing directly in the form. Once completed, the form can be printed and signed and submitted via e-mail or USPS to the CSU for processing. The new form includes a link to the professions regulated by the Department as well as a link to look up the license number of the subject; assisting both the complainant and enforcement in more easily identifying the subject of the complaint. The new form is easier to read and will also assist all involved in opening a more succinct and accurate complaint. The new form is easy to find on our website at: