Q:  How can I obtain a complaint form?

A:  You may request a complaint form from the Board's Public Inquiries section by calling (800) 554-7717, or by submitting a request in writing to:  Public Inquiries, State Medical Board of Ohio, 77 South High Street, 17th Floor, Columbus, Ohio 43215-6127.  You may also download a copy of the form here.

The Board asks that you file your complaint in writing.  Doing so may expedite the initial processing of your complaint and provides you with protections found in 4731.22(F)(1), ORC, which says that absent bad faith, an individual who files a signed complaint with the Medical Board is not liable for damages in a civil action.  

Please fill out each section.  Individual identifying information may be important during the investigation of a complaint.  The Board is required to keep the name of complainants confidential unless a signed release form is obtained.  You may attach a letter or add pages to this form.

All complaints are reviewed by the Secretary and Supervising Member of the Board.  These individuals are charged with overseeing all of the Board's investigations.  You will receive notification of the outcome of your complaint.  If you have any questions regarding this form or the complaint process please contact the Public Inquiries Section of the State Medical Board.