The ongoing monitoring and investigation of grievances regarding the care given by hospitals and diagnostic and treatment facilities, including ambulatory surgical centers, dialysis centers, and primary care clinics in New York State, is the responsibility of the New York State Department of Health.In general, only complaints about problems that occurred within the last year will be taken into consideration. However, NOT all complaints will be assigned for investigation Please note that complaints must be submitted in writing
Please check and choose from the Subject Drop-Down List before submitting a complaint, concern, or inquiry to see if your query or issue can be directed to other offices within the Department of Health or to another State agency.You can submit each question on its own if you have several that are related to various topics. You will receive a quicker responseIf you would still like to file a complaint after reviewing the list, proceed to the form below to do so.
The Facility Complaint Form should be filled out completely and submitted electronically below, or printed here and mailed to:
Centralized Hospital Intake Program of the New York State Department of Health Mailstop: CA/DCS Empire State Plaza Albany, NY 12237
Call the toll-free number at 1-800-804-5447 if you are unable to submit this form electronically or print it. Someone will help you.
Please be aware that all complaints are evaluated by qualified clinical staff in accordance with established standards to determine whether they will be subjected to an investigation.The outcome of this review will be communicated to you in writing.The outcome of this decision will not be impacted by any correspondence sent in the future about the same issues.
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Facility Complaint Form Patient Information First Name Last Name Facility Information Facility Name Facility Address Complaint Information
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