NOTE: From 02/06/2023 6:00 PM to 02/06/2023 7:00 PM ADHS Licensing Services online complaint submission system will be offline for maintenance. During this time you will not be able to use the site.

ADHS Licensing Complaint Submittal Form

Online Complaint Submittal Form - Long Term Care Licensing

The Division of Licensing Services Bureau of Long Term Care Licensing provides this Online Complaint Form which allows anyone with knowledge or concerns about a suspected rule violation to submit a complaint through this web page. A complaint is a suspected violation of Arizona state rules and/or statutes governing the operations of licensed Long Term Care Nursing Homes and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID).

Please review the following prior to submitting the complaint allegation.

Complaint Frequently Asked Questions (FAQs)

When filling out this form, information that is required is indicated by a red asterisk (*). Click "Start" to begin complaint.