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Professional Licensing and Certification Unit Complaint Forms and Instructions

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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, you may be contacted for additional information.  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.

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Last updated August 26, 2011