Complaint and Report Form (Nurses)
Use this form if:
  • you need to file a complaint or report about a(n):
    • Registered Nurse (RN),
    • Licensed Practical Nurse (LPN),
    • Advanced Registered Nurse Practitioner (ARNP), or
    • Nursing Technician
  • you are a nurse who needs to self report
Looking for a different complaint form? See other options below:
  • See this form to file a complaint about a nursing education program or a nursing assistant training program.
  • See this webpage if you need to file a complaint about another profession.