CDHS Individual Complaint Form
Please use this form to share your concern or complaint with the Colorado Department of Human Services. Your responses will be sent to CDHS's client services liaison and will be kept confidential.

If you choose to submit an anonymous complaint you may indicate that on the form. You will not be notified of any action taken as a result of this complaint.
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Which program service area is your concern about? *
Client first name *
Client last name *
Client county *
Date of concern
MM
/
DD
/
YYYY
Client case number
Please describe the issue or reason for your concern.
Provide as much detail as possible, including times and dates of events where appropriate.
Your first name *
Your last name *
Your phone number *
Your email *
Additional comments
Is there anything else we should know so that we can address your concern?
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