The form asks you to provide a clear statement of the problem you are having. In this statement, include important information and relevant dates.Information on how TDLR handles complaints, handles alleged violations, issues enforcement actions, conducts hearings, and processes for judicial review. Fill in the name and address of the person or organization of where you want us to send the requested information. We can release records to other physicians or health care facilities without your consent for follow-up care or if it is a medical emergency. The investigations section will provide guidance to newly appointed investigating officers to ensure an investigation complies with what the JAGMAN requires. Examples of questionable reports include: Previous reports of abuse or neglect that have been determined to have fabricated allegations. The information you provide will be used to complete a background investigation that will determine your eligibility for employment. Enter the ID Code provided to you in the field below. Include payment in the form of a personal check, money order, or cashier's check made payable to TxDMV.