Professional Licensing and Certification Unit
Complaint Forms and Instructions
When you have finished reading this page, please click the correct menu item to return to the board or program home page, or click the BACK button
in your browser to return to the previously viewed page.
If you wish to file a complaint, this page contains links to copies
of complaint and general release forms, and the instructions necessary
to complete the forms correctly. The documents are available in Adobe
Acrobat and MSWord format. Please provide as much information
as possible to assist in the successful resolution of your complaint. You
may also wish to download a copy of the relevant law and rules from
the home page of the specific board or program with which you intend
to file your complaint. Should you have any questions about completing
the packet, please feel free to call 1-800-942-5540, or the specific
board or program office with which you are filing your complaint.
Complaint Form Packet
in MS Word format
(select the links below to download all documents)
Complaint Form (Word format,
44 KB)
Complaint Form Instructions (Word format, 31
KB)
General Release Form (Word Format, 57 KB)
Complaint Form Packet
in Adobe Acrobat format
(select the links below to download all documents)
Complaint Form (Adobe Acrobat
format, 36 KB)
Complaint Form Instructions (Adobe Acrobat
format, 28 KB)
General Release Form (Adobe
Acrobat format, 41 KB)
To access documents in Adobe Acrobat format, you must download the Acrobat
Reader software. Please see the DSHS file
viewing page for more information and a link to the Adobe website.
To
file a complaint, you will need to complete the Complaint and the General
Release forms. Return both forms and any additional supporting
documentation to the address shown on the complaint form.
After the completed complaint packet is returned, you will be notified
by letter acknowledging that your complaint has been received. The
complaint will be reviewed to verify that the statement indicates a potential
violation of law or rules. If your complaint indicates a potential
violation, we will notify you of the status of your complaint approximately
every 90 days, until final action is taken. Should your complaint
not indicate a potential violation of law or rules, we will also notify
you.
A complaint may be filed anonymously by not providing your name and address
on the form; however, please be aware that anonymous complaints may be
difficult to investigate and many are closed because insufficient information
is provided. When you provide your name and address, our investigative
staff will be able to contact you for additional information which may
be necessary to resolve your complaint.
In some instances, a complaint may be investigated informally by staff.
In other cases, investigations are conducted by a Texas Department of
State Health Services investigator. The complaint may be investigated
by telephone, mail or personal interviews. Information and/or
documentation will be collected that is relevant to the complaint.
After the investigation is completed, the report of investigation will
be forwarded to the program for appropriate action. You may contact
the board or program office at any time regarding the status of your complaint.
When you have finished reading this page, please click the correct menu item to return to the board or program home page, or click the BACK button
in your browser to return to the previously viewed page.
Last Updated October 10, 2007
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