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1545 Mockingbird Lane,
Suite 3005
Dallas, TX 75235
(214) 819-9911 v
866-705-7542
(214) 819-9944 f

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608 Morrow Street,
Suite 103
Austin, TX 78752
512-451-3191 v
800-860-6057
512-451-8302 f

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Complaints About A Provider

This form offers an opportunity to bring mental healthcare provider problems to our attention. Submissions will be investigated rigorously.

Who is the provider

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Individual:

Service:

Occurred On (Date):

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City: *

State:

Zip:

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