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PRINTED: 10/03/2016 FORM APPROVED Indiana State Department of Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION NUMBER:(X3) DATE SURVEY COMPLETE DRC
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Form investigation of complaint is a document used to report a complaint to the appropriate authorities for further investigation.
Any individual or organization that has a valid complaint can file a form investigation of complaint.
To fill out a form investigation of complaint, provide detailed information about the complaint, including the nature of the complaint, the individuals involved, and any supporting evidence.
The purpose of form investigation of complaint is to document and investigate complaints in a formal manner to address any issues or concerns.
Information such as the complainant's contact information, description of the complaint, individuals involved, and any supporting evidence must be reported on a form investigation of complaint.
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