Health Facility Complaint Intake Form
We regulate facilities that offer health care services such as hospitals, nursing homes, assisted living residences, and home care agencies. This is a quick form to begin the process of filing a complaint for one of the facilities that we regulate.

We do not regulate: 
  • restaurants
  • veterinary clinics
  • apartment complexes
  • urgent care
  • individual physicians 

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What type of facility are you wanting to file a complaint for? *
The facilities are grouped by:
  • Acute care services - you go to a facility for care and then you go home.
  • Residential care services - a facility you live in and receive care at.
  • Mental health services - services that may be at a facility or in your home.
  • Home and community service - services that you receive in your home.
Health Facility / Agency Name *
Facility Location *
Address, city or county
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Dieses Formular wurde bei State.co.us Executive Branch erstellt.

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