Complaints
Complaints
- Online Consumer Complaint
- Online Employer Complaint
- Online Program Complaint
- VDAP Application/Self-Report

Consumer Complaint Form

Please use one form for each person you are reporting. To report on multiple nurses, please enter the details again into a fresh form after submitting the previous complaint.

Please provide as much information as possible below, including your name and contact information. The Alabama Board of Nursing does not process complaints from anonymous or deliberately misleading sources.

Nurse and Complaint Details

Nurse's Name:*

Nurse's License Type:

LPN

CRNP

CRNA

CNM

CNS

Nurse's License:

Your relationship to the nurse:

Date of birth of patient:

Explain what happened:*

(including what, when, and where)

Name, address, and phone of any witnesses:

Did you report this to anyone else?:

Yes

Hospital administration, physician, law enforcement, etc

Where does the nurse work?:

City:

State:

Your Details

Name:*

Address:*

City:*

State:*

Zip:*

Email:

Invalid value

Phone:*

Submit Complaint