File a Complaint

Please see sidebar for examples of what we can and cannot help you with. If the agency is not in our jurisdiction, the Ombudsman Office probably cannot help you except to refer you to the right place.

Before completing this form, please review it in its entirety to ascertain whether we can help you. AZOCA may be able to assist you if a state administrator has treated you unfairly, you disagree with an administrative act of a state agency, department, board, or commission, or if you have disputes with local government agencies regarding public access laws. If the agency is not in our authority, or you have come to us prematurely in the administrative complaint process, then we cannot investigate the matter. However, we may discuss your options with you and guide you to the right place to file your complaint. Please be thorough in completing the form.

Complaint Form

Please fill out as much as you can and press Send below.

    Name (Required):
     
    Email:

     
    Phone:

     
    Address:

    City:
    State
    Zip:
     
    Agency name(s) that your complaint is about:

     
    Complaint (Required):

     
    What resolution are you seeking from our agency?

     
    What steps have you taken to resolve the problem with the agency? Please include names of people you have worked with and other offices you reported the complaint to. *Note: Arizona laws require one to give the agency the opportunity to solve the problem before AZOCA is allowed to investigate.
     
    Wrote a complaint and sent it to the agency's email, fax, mail.
     
    Called the agency at telephone #:
     
    Spoke to agency member or management staff:
    Spoke to the agency's internal ombudsman office on (date):
    Appealed on: (date):
    Please explain further resolution attempts or details if you wish:

     
    Please note the agency case number, license number, or another identifier with this agency if the agency has informed you of one. However, do not send us tax identification or social security numbers. Examples: VIN, ATLAS, EIN, Driver License #, DCE Person ID, AHCCCS number, court case #, etc. For DCS cases, please include the mother and children's names and birth dates.

     
    Confidentiality with the agency
    In most situation you are already known to the agency, and/or we must identify you as the complaintant to investigate the dispute with the agency. However, sometimes this is not the case. IF you need this complaint to be anonymous to the agency, then you must inform us of that request upfront. If you do require confidentiality, we may not be able to help resolve your complaint, but we may discuss it with you.

     
    Information Release Forms Are Required for Certain Agencies
    A few agencies are subject to specific laws requiring they obtain information release forms before the agency may share information with us. If your complaint is about AHCCCS, the Department of Revenue, DES Child Support, DES Nutrition Assistance, or DES Unemployment Assistance, request a form.