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PRINTED: 06/17/2024 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION
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Access the licensure and complaint survey form on the appropriate website or platform.
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Fill in your personal details, including name, contact information, and any relevant licensure information.
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Who needs licensure and complaint survey?

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Individuals who have licensure concerns or complaints regarding a specific product, service, or professional.
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Licensure and complaint survey is a mandatory process where professionals or organizations are required to report their licensure status and any complaints filed against them.
Professionals or organizations holding a license or certification in a specific industry are required to file licensure and complaint survey.
Licensure and complaint survey can be filled out online through the designated portal provided by the regulatory body. The survey typically requires information about licensure status, any complaints filed, and contact information.
The purpose of licensure and complaint survey is to ensure transparency and accountability in professional practices by monitoring licensure status and complaints filed against professionals or organizations.
Information that must be reported on licensure and complaint survey includes licensure status, any complaints filed, contact information, and any disciplinary actions taken.
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