Division of Licensing and Certification →
Safety & Reporting →
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.
Date and Time of alleged vaccine eligibility administration non-compliance