Complaint form below and we will work rapidly to respond. Before You Submit a Complaint.Request a Verification Letter. We provide former foster youth in California with Dependency Letters (also called Verification Letters or Ward of the Court LONG-TERM CARE OMBUDSMAN COMPLAINT FORM. Complete our complaint form (PDF) or draft your own complaint and submit via email, fax, or mail. You may also file a complaint over the phone. Phone. If a complaint has been referred to another agency and that agency acts on the complaint and reports the final outcome to the ombudsman program, code in the. Airline Name: Flight Number: Date: In order for your complaint to be considered complete, you must file within 180 days of the alleged act of discrimination. Fill out this form to complain about language access services in the California courts.