Get Website Address - Texas Optometry Board

This guide provides a comprehensive overview of how to effectively complete the Texas Optometry Board complaint form online. By following these instructions, users can ensure they provide all necessary information clearly and concisely.

Follow the steps to accurately complete your complaint form online.

1. Click the ‘Get Form’ button to access the complaint form in your editor.
2. Fill in your personal information, starting with your full name. This section is critical for identifying who is filing the complaint.
3. Enter your address in the specified fields, including street address, city, state, and zip code to provide your contact details.
4. Next, provide details about the optometrist or individual you are reporting. Include their full name and license number where indicated.
5. List the office location of the optometrist. Make sure to fill in the city, state, and zip code accurately to avoid any miscommunication.
6. In the section labeled 'Incident being reported,' clearly describe the nature of your complaint. Be specific about the events that occurred and include what resolution you are seeking.
7. Attach any necessary supporting documentation by making photocopies and referring to them in your description, or add additional sheets if needed.
8. Review your statements and sign the form. Ensure that your signature and date are accurately entered, as this confirms the truthfulness of your information.
9. Complete the authorization to release patient records section by signing and dating it as well. This ensures that the Texas Optometry Board can conduct a thorough investigation.
10. After filling out all required sections, save your changes, and consider downloading or printing a copy of the completed form for your records.

Complete your complaint form online today to ensure your concerns are heard.