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OmbudsContactFormInstructions:
UsethisformtocontacttheOmbudsOfficeifyourproblemorissuehasnotbeenresolvedby:calling
theServiceCenter, filingaCoveredCaliforniacomplaint, orfilinganappeal. Ifyouhavetriedoneofthe
methodslistedandstillhavebeenunabletoresolveyourproblem,
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What is usethisformtocontactformombudsofficeifyourproblemorissuehasnotbeenresolvedbycalling?
This form is to be used to contact the ombuds office if your problem or issue has not been resolved by calling.
Who is required to file usethisformtocontactformombudsofficeifyourproblemorissuehasnotbeenresolvedbycalling?
Anyone whose problem or issue has not been resolved by calling is required to file this form.
How to fill out usethisformtocontactformombudsofficeifyourproblemorissuehasnotbeenresolvedbycalling?
To fill out the form, provide details of your problem or issue and any attempts made to resolve it through calling.
What is the purpose of usethisformtocontactformombudsofficeifyourproblemorissuehasnotbeenresolvedbycalling?
The purpose of this form is to escalate issues that have not been resolved through phone calls to the ombuds office.
What information must be reported on usethisformtocontactformombudsofficeifyourproblemorissuehasnotbeenresolvedbycalling?
The form must include details of the problem or issue, attempts made to resolve it through calling, and contact information.
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