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  • Dental Complaint Form ( Pdf ) - Mass . Gov - Mass

Get Dental Complaint Form ( Pdf ) - Mass . Gov - Mass

DENTAL COMPLAINT FORM DPH Date Rec d (stamp) DEPARTMENT OF PUBLIC HEALTH DIVISION OF HEALTH PROFESSIONS LICENSURE OFFICE OF PUBLIC PROTECTION TEL (617) 973-0865 FAX (617) 973-0985 TTY (617) 973-0895.

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Any person who has knowledge of conduct by a licensed nurse that may violate a nursing law or rule or related state or federal law may report the alleged violation to the board of nursing where the conduct occurred. All jurisdictions have specific processes for complaint intake. Contact the Board of Nursing.

You will need to describe your relationship with the patient (e.g. parent of the patient) and why the patient is unable to lodge the complaint personally. Provide a summary of the date(s) / time and location(s) of the incident(s). List the allegations against each dentist/OHT and provide details.

How to file By mail + You can send your written complaint to the RMV at: Registry of Motor Vehicles. Driver Licensing Department. P.O. Box 55889. Boston, MA 02205-5889. By fax + You can fax your complaint to the RMV at (857) 368-0820. Online + You can email your complaint to the RMV at DriverEd.Registry@state.ma.us.

By mail + Choose the complaint form you need, depending on the practice type. Forms are listed below under Downloads. Dental. Genetic Counselor. ... Fill out the form. Attach any and all supporting documentation. Mail to: Department of Public Health. Bureau of Health Professions Licensure. Attn: Office of Public Protection.

If you have a complaint about a local food business, you can call us at 617-635-5326, Monday through Friday, 8 a.m. - 4 p.m. You can also call or contact 311.

If you are not able to provide a written complaint, you may call our 24 hour consumer complaint line at (800) 462-5540 or (617) 753-8150.

Complete a Complaint Form and submit it to the Board....Please include the following information about the incident you are reporting: The nurse's name. The nurse's license number, if you have it. Location. Date. Any documentation to support your complaint, such as medical records. Your contact information.

File a complaint by calling the Intake Investigator at (617) 371-9500 or (888) 485-4766. Intake Investigators are generally available to take calls between 9:00 a.m. and 4:30 p.m., Monday through Friday.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232