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State of Iowa

info@iowa.gov

200 E Grand, Des Moines , IA, 50309, US

Iowa Board of Medicine Complaint Form

One of the most important ways the Iowa Board of Medicine protects consumers is by investigating their complaints against physicians.  This form helps the Board collect basic information to review your complaint.  For an explanation of the complaint investigation process, please visit the Board's Enforcement page of the website, at https://medicalboard.iowa.gov/physicians/enforcement or call  515-281-5171.  Please provide the following information so that the Board can acknowledge receipt of your complaint and contact you should additional information be needed:

 

Complainant Information

Complainant's Name

Complainant's Full Address

Patient Information

Patient's Name

Patient's Address

Patient's Date of Birth

Physician Information

Please provide the following information about the physician(s) who is the subject of your complaint:

Physician 1 (Name)

Physician Office Address

Physician 2 Name

Physician 2 Office Address

Physician 3 Name

Physician 3 Office Address

Complaint Information

Questions About Complaint

Your Expectations