ADHS Licensing Complaint Submittal Form

Online Complaint Submittal Form - Special Licensing

The Division of Licensing Services Bureau of Special 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 Medical Radiologic Technologists and Laser Technicians.

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.