This form is for the use of persons who wish to file a complaint with the Division of Professional Regulation against a professional licensee, registrant or certificate holder or against a person/business practicing or operating without the required professional license.
If you are a Delaware-licensed healthcare provider or other entity that is required to report a healthcare provider under your mandatory duty to report, please submit the Report of Healthcare Provider instead of this form. If you need to report child abuse or neglect, see Mandatory Reports of Child Abuse or Neglect on the Division’s website.
In order for the Division to start an investigation of possible violation of Delaware licensing, registration or certification laws and regulations, you must complete this online form. Be sure to submit any documents you may have to support your complaint by faxing them to (302) 739-2711, or email them to firstname.lastname@example.org. Delaware law allows the Division to keep the name of the person who files a complaint confidential, when appropriate.
Fields marked with ** are required by law in order to accept your complaint. Your complaint may be rejected if you leave any portion of a required field blank.
If you need help completing this form, call (302) 744-4500 and ask to speak to an investigator.