Case Management Agency Complaint Form  

All Case Management Agencies have a formal Grievance and Complaint Policy. Please ensure that you have reached out to the Case Manager, Supervisor, or Director to report your concerns by requesting this formal process prior to completing this form.

The Case Management Unit will review your complaint and work with the current Case Management Agency to address and resolve your concerns. The Department notes that you may not have direct contact from our staff if we are able to address your concerns through our internal process.  

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Email *
Name of person completing this form *
Please give us your email address and/or phone number. If you don't give us your email address, you will not receive an email confirmation of your complaint. *
Are you completing this form for yourself or for someone else? *
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