Report A Critical Incident

The Office of Licensing (OL) Code of Conduct and Client Rights (R501-1-11-1(p)(i)), requires any licensee or staff member who is aware of, or suspects abuse, neglect, harm, mistreatment, fraud or exploitation to ensure that a report is made to OL. We investigate all reports. If a critical incident has occurred at your facility, please report it using the form below.

Please view the DHS Incident Reporting Guide to assist in understanding what constitutes an incident, what needs to be reported, and how it should be reported and documented.

If you are a member of the public with a concern about a licensed or unlicensed facility, please fill out the Submit A Concern form instead of the one below.

**For critical incidents related to COVID-19, please click here**  

**NOTE** The link to this page has been updated. If the form is not working, please click here and update your shortcut.

Note: All fields are required to be filled out.