File a Vaccine Eligibility Site Complaint

File a Vaccine Eligibility Site Complaint

Individuals wishing to file a complaint of potential vaccine administration non-compliance relating to the COVID-19 vaccine guidance may report those details using this form.  The information will be reviewed by the Division of Licensing and Certification or appropriate agency or agencies and responded to as needed.

Please visit the Governor’s website for the most up-to-date information.

Complaint Form

Date and Time of alleged vaccine eligibility administration non-compliance

Nature of ineligible vaccination
  • March 23, 2021 50 and older are eligible
  • April 19, 2021 All people over the age of 16 are eligible
Evidence of non-compliance