You may complete the online form and an Ombudsman can assist you with completing the US Department of Health and Human Services required forms. Use the following definition of complaint, which is also provided in Part I, C, page 1 on the hard copy of the reporting form.The Ombudsman Complaint Action Form is located in the Appendix. First, choose the consumer complaint form that fits your problem. You must have a current Ombudsman ID to complete the Ombudsman Complaint Form. An Ombudsman complaint can be filed Monday-Friday at phone number 518-417-6587. Long-Term Care Ombudsmen assist residents of long-term care facilities in exercising their rights and attempting to resolve grievances. Field 1: Fill in the county in which the action is brought. Be consistent with other forms. Intake: Complaints filed with Ombudsman are assigned to an investigator.