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Complaint Against WIC Staff

Complaint Against WIC Staff

  • Witness Contact Information

    Your 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.
  • Complaint Type

  • Complaint Information

  • Date Format: MM slash DD slash YYYY
  • :
  • If you don't know/remember the staff members name, please do your best to describe their physical appearance.
  • What happened?

  • This field is for validation purposes and should be left unchanged.