The Ombudsman Complaint Log requires the use of Facility. Codes, which are provided the Nursing Home and Personal Care.Please use the form below to contact us. We provide advocacy and informal resolution of concerns of residents in long-term care facilities. The defendant shall in like manner verify any answer. We ask that you please do not use this form if you need to report a crime, need a police officer or need any kind of police assistance or immediate assistance. The preferred method for submitting a concern is through our online submission form as it allows for more direct, timely receipt and review of your concerns. Please complete the electronic Complaint Form to submit a formal complaint. Choose a complaint type below to begin. Objectively determine whether complaints are verified or not verified.