Individual Health Care Provider Complaint Form - Connecticut

Individual Health Care Provider Complaint Form is a legal document that was released by the Connecticut State Department of Public Health - a government authority operating within Connecticut.

FAQ

Q: What is the Individual Health Care Provider Complaint Form?
A: The Individual Health Care Provider Complaint Form is a form used in Connecticut to report complaints about health care providers.

Q: Who can file a complaint using this form?
A: Any individual who has a complaint against a health care provider in Connecticut can file a complaint using this form.

Q: What information is needed to fill out the form?
A: The form asks for information such as the name of the health care provider, the date of the incident, a description of the complaint, and the contact information of the person filing the complaint.

Q: How can I submit the complaint form?
A: The completed complaint form can be submitted by mail or fax to the Department of Public Health in Connecticut.

Q: What happens after I submit the complaint?
A: After you submit the complaint, it will be reviewed by the Department of Public Health, and they will determine the appropriate action to take.

Q: Is my complaint confidential?
A: The Department of Public Health treats complaints as confidential, but they may be subject to disclosure under the Freedom of Information Act if required.

Q: Is there a time limit for filing a complaint?
A: There is no specific time limit for filing a complaint, but it is recommended to file as soon as possible after the incident occurs.