ADHS Licensing Complaint Submittal Form

Online Complaint Submittal Form - Medical Facilities Licensing

The Division of Licensing Services Bureau of Medical Facilities 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 medical facilities.

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.