Complaint Against WIC Participant Anonymity I would like to be anonymous Witness Contact InformationYour name and at least ONE contact method is needed for the State Office to be able to follow up on this complaint. If 'anonymous' is selected, we will not share your name with the Clinic.Name* First Last Home PhoneCell PhoneEmail Complaint TypeYou may check up to four (4) complaint types. Attempting to purchase foods not approved by WIC Threatening or verbally abusive towards cashiers or WIC staff Physically abusive towards cashiers or WIC staff Causing clinic/store disruption Inappropriate use of food instruments (no signature, using early) Misrepresentation of eligibility information (income, family size) Dual Participation Sale of WIC items obtained through WIC(formula, breast pumps) Exchanging food instrument(s) for credit or non-food items Altering food instruments Using food instruments at an unauthorized store Stealing WIC food instruments Stealing WIC foods Trafficking of items obtain through WIC (formula, food instruments) Record Request Complaint InformationDate of Incident* MM slash DD slash YYYY Time of Incident : Hours Minutes AM PM AM/PM Which clinic?Select WIC ClinicUnknownCarson City Health and Human Services - Clinic #427 - 1524 Hwy 395 Suite 8, Gardnerville, NV 89410Carson City Health and Human Services - Clinic #455 - 900 East Long Street, Carson City, NV 89706Catholic Charities - Clinic #801 - 1511 N. Las Vegas Blvd., Las Vegas, NV 89101Catholic Charities - Clinic #802 - 270 E. Horizon Suite 109, Henderson, NV 89015Community Health Alliance - Clinic #312 - 3915 Neil Road, Reno, NV 89502Community Health Alliance - Clinic #313 - 5055 Sun Valley Blvd Suite #100, Sun Valley, NV 89433Community Health Alliance - Clinic #314 - 2244 Oddie Blvd., Sparks, NV 89431Community Health Alliance - Clinic #315 - 1100 East 8th Street, Reno, NV 89512Community Health Alliance - Clinic #316 - 2405 Vassar St., Reno, NV 89502Community Health Alliance - Clinic #317 - Mobile ClinicCommunity Health Alliance - Clinic #318 - 280 Vista Knoll Pkwy. Ste. 107, Reno, NV 89506Consolidated Agencies of Human Services - Clinic #409 - 924 5th Street, Hawthorne, NV 89415Family Resource Centers of Northeastern NV - Clinic #417 - 331 7th Street, Elko, NV 89801Little People's Head Start - Clinic #413 - 121 Joshua Tree St., Alamo, NV 89001Little People's Head Start - Clinic #414 - 100 Depot Ave., Caliente, NV 89008Little People's Head Start - Clinic #426 - 435 S. 13th Street, Bldg. B, Ely NV 89301Lyon County WIC - Clinic #419 - 26 Nevin Way, Yerington, NV 89447Lyon County WIC - Clinic #420 - 5 Pine Cone Rd. #103, Dayton, NV 89403Lyon County WIC - Clinic #424 - 105 Lois Lane, Fernley, NV 89408Lyon County WIC - Clinic #428 - 620 Lake Ave., Silver Springs, NV 89429Nevada Health Centers - Clinic #204 - 1700 Wheeler Peak Drive, Las Vegas, NV 89106Nevada Health Centers - Clinic #205 - 5486 Boulder Hwy. Suite 102, Las Vegas, NV, 89122Nevada Health Centers - Clinic #206 - 5085 W. Sahara Ave. Suite 134, Las Vegas, NV 89146Nevada Health Centers - Clinic #208 - 3650 N. Rancho Dr Suite 101, Las Vegas, NV 89130Nevada Health Centers - Clinic #209 - 5001 E. Bonanza Rd Suite 104, Las Vegas, NV 89110Nevada Health Centers - Clinic #601 - 2225 Civic Center Dr. Suite 150, North Las Vegas, NV 89030Nevada Health Centers - Clinic #602 - 3900 Cambridge Ave. Suite 202, Las Vegas, NV 89119Northern Nevada Public Health - Clinic #301 - 601 West Moana #3, Reno, NV 89509Northern Nevada Public Health - Clinic #302 - 1001 East 9th Street, Reno, NV 89502Northern Nevada Public Health - Clinic #306 - 880 Alder Ave., Incline Village, NV 89451Nye County WIC - Clinic #406 - 1 Frankee Street, Tonopah, NV 89049Nye County WIC - Clinic #505 - 1981 E. Calvada Blvd. Suite 100, Pahrump, NV 89048Pershing County WIC - Clinic #403 - 370 S Mountain, Battle Mountain, NV 89820Pershing County WIC - Clinic #421 - 775 Cornell Street Suite B, Lovelock, NV 89419Pershing County WIC - Clinic #422 - 26 E. Haskell Street, Suite B, Winnemucca, NV 89445Pershing County WIC - Clinic #425 - 993 W. Williams Ave., Fallon, NV 89406Ron Wood Family Resource Center - Clinic #423 - 2621 Northgate Lane #62, Carson City, NV 89706St. Rose WIC - Clinic #720 - 2651 Paseo Verde Pkwy., Henderson, NV 89074St. Rose WIC - Clinic #721 - 7220 S. Cimarron Rd. Suite 195, Las Vegas, NV 89113St. Rose WIC - Clinic #722 - 102 E. Lake Mead Pkwy., Henderson, NV 89015Sunrise Children's Foundation - Clinic #501 - 3838 Meadows Lane, Las Vegas, NV 89107Sunrise Children's Foundation - Clinic #502 - 1000 E. Sahara Ave. Suite 101, Las Vegas, NV 89104Sunrise Children's Foundation - Clinic #503 - 3601 N Las Vegas Blvd. Suite 102, Las Vegas, NV 89115Sunrise Children's Foundation - Clinic #504 - 355 W. Mesquite Blvd. Suite D15, Mesquite, NV 89027Sunrise Children's Foundation - Clinic #803 - 4311 Carswell ave. #401, Las Vegas, NV 89191Urban League WIC - Clinic #650 - 6480 W. Flamingo Dr. Suite B, Las Vegas, NV 89103Urban League WIC - Clinic #651 - 3320 E. Flamingo Suite 50, Las Vegas, NV 89121Participant Name* First Last What happened?Describe the IncidentCommentsThis field is for validation purposes and should be left unchanged. Δ