Complaint Form

Complainant Information

All of the information with * next to them are required.
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Complaint Information

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Click here to verify a license number.
If the Complaint is on a Facility, please get in touch with the NC Department of Health and Human Services. If the Complaint is on an Individual that doesn't have a license, you may use the form above to file the Complaint by using the License Number "0" (zero).
I certify that I am the person shown above, and all the information is correct.