Get Doh Form 3867

Filling out the Doh Form 3867 online can be straightforward with the right guidance. This document serves as a comprehensive resource to help you understand each component of the form and ensure your submission is accurate.

Follow the steps to complete the Doh Form 3867 online with ease.

1. Click ‘Get Form’ button to access the form and open it in your online editor.
2. In the 'Information about you' section, enter your full name, including last name, first name, and middle initial. Complete your address details, including house number, street name, city, state, and zip code. Provide your contact numbers for both evening and daytime.
3. In the 'Your complaint regarding a physician or physician assistant' section, fill in the name and address of the physician or physician assistant involved. Include their telephone number for further clarification if necessary.
4. In the 'Information about the patient(s)' section, enter the patient's name and date of birth. You may add more patient names on a separate sheet of paper if needed.
5. In the 'Details of your complaint' section, describe your complaint as completely as possible. Include any relevant details such as the date and location of the incident. Indicate whether you have filed a complaint with any other organization and provide names if applicable.
6. If there were witnesses to the incident, include their names in the designated area. You may add additional names on a separate sheet if necessary.
7. Once all sections are completed, review the form for accuracy. Ensure your signature and the date are included at the bottom of the form.
8. Finally, save your changes to the form. You can now download, print, or share the form as required.

Complete your Doh Form 3867 online today and ensure your complaint is processed efficiently.