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Division of Quality Assurance (DQA) - Misconduct Report or Complaint about Care or Treatment, F-00607 (02/2023)

Welcome


Thank you for contacting the Wisconsin Department of Health Services - Division of Quality Assurance.

You may use this form to report abuse, neglect, or misappropriation by an employee or contractor of a Wisconsin treatment provider or facility, or to report a concern about care or treatment.

This includes incidents or concerns occurring in health care facilities, such as hospitals and nursing homes, assisted living communities, and other programs that provide care and treatment services in your home or in the community.