This form is a sample complaint for use in a personal injury case involving the injury of the plaintiff due to a gunshot wound inflicted by the defendant.
South Dakota Complaint regarding Gunshot Injury
State:
Multi-State
Control #:
US-PI-0264
Format:
Word;
Rich Text
Instant download
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Public form
Description
How to fill out Complaint Regarding Gunshot Injury?
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FAQ
The form is available here or call NDHIN at (855) 761-0534. The complaint form may be submitted by mail or electronically. If the complaint relates to a suspected violation or breach of PHI, the complaint must be filed within 180 days from the date of becoming aware of a suspected violation.
To file a complaint against a physician or specialist, contact your state medical board. The Directory of State Medical and Osteopathic Boards can be accessed from the Federation of State Medical Boards (FSMB) website.
Whether you download the consumer complaint form or fill out the online complaint form, please make sure to keep copies of your completed form and copies of any relevant documents. If you would like a form mailed to you, please call 1-800-300-1986 (in-state) or 1-605-773-6585 for the hearing impaired.
South Dakota Board of Medical & Osteopathic Examiners. 101 N Main Ave Suite 301. Sioux Falls, SD 57104. (605) 367-7781. Please note: The SDBMOE does not have jurisdiction over complaints against other health disciplines or facilities listed: SDBMOE ? Complaint Committee. 101 N. Main Ave Suite 301. Sioux Falls, SD 57104.
How long can I expect the South Dakota medical licensing process to take? The average time for obtaining a South Dakota medical license is 12-16 weeks. However, it can take longer.
Any physician, nurse, or employee thereof and any employee of a hospital, sanitarium, clinic, or nursing home knowingly treating any person suffering from a gunshot wound or life-threatening injury indicating an act of violence, or receiving a request for such treatment, shall report the same immediately to the ...