Recipient Rights Complaint Form

Submit A Concern Form

If you believe that one of your rights has been violated, you (or someone on your behalf) may use this form to make a complaint. A rights officer/advisor will review the complaint and may investigate. You will submit this form online, or you can also complete a paper version here.

If you send your complaint to Michigan Department of Health and Human Services, Office of Recipient Rights (MDHHS-ORR), it will be forwarded to the appropriate rights office. The MDHHS-ORR address is, Office of Recipient Rights, 235 South Grand, Suite 216, PO Box 30037, Lansing MI 48909.

The Michigan Department of Health and Human Services (MDHHS) does not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, genetic information, sex, sexual orientation, gender identity or expression, political beliefs, or disability.
Authority: PA 258 of 1974 as amended.
DCH-0030 (Rev 09-20) Previous edition obsolete Copy to complainant with acknowledgement letter