Resources & Information

Healthcare Professionals Reporting Form

Healthcare professionals should use this form to report licensee misconduct or substandard care, including mandatory reports about licensee sexual misconduct or prescribing misconduct as specified in NCGS 90-5.4.

Before submitting a complaint/report, be sure to gather addresses and contact information for anyone the Board may need to follow up with (e.g. the licensee being reported, potential witnesses, others involved). Photos, documents or other files related to the incident may be uploaded and sent to the Board with your report.

indicates required field

Please provide your contact information:
Information about the licensee you are reporting:
Reason for Report
Has this incident been reported to any other entity or law enforcement?
Attachments
(medical records, correspondence, etc.)

You will receive an auto reply to the email entered above. If you do not receive this email, your submission was not received.

You may contact the Investigations Department if you have any issues or questions.