Patient Complaint Form

The New York City Department of Health and Mental Hygiene reviews complaints related directly to patient care and services that are provided in the clinics and home visiting programs. To file a complaint about the treatment you received you may do any one of the following:

Call 311
Submit the form on this page.
Fill out a physical form and mail it to:

New York City Department of Health and Mental Hygiene Division of Administration Office of Clinical Quality Management and Improvement 42-09 28th Street, CN 45A Long Island City, New York 11101

Complaints will be reviewed by professional staff to determine if the statements are within the regulatory jurisdiction of the NYC Department of Health. If you have any questions or concerns about the patient complaint form, call Patient Relations at 347-396-6404.

When submitting this complaint form, please:

Print clearly and fill out as much information in English as you can.
If possible, include the names of those you are filing a complaint against.
If applicable, attach copies of documents that may support your complaint. Please do not send originals.

If you are not satisfied by the NYC’s Department of Health and Mental Hygiene’s response, you may complain to New York State Department of Health Centralized Hospital Intake Program
Mailstop: CA/DCS
Empire State Plaza
Albany, NY 12237