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Complaints can be filed no more than 90 days statutory limit from the date of incident.

If sending complaint via US Post - please send attention to: "License Complaints Department" on the mail address.

License Complaints Department
ACDHH
100 N. 15th Ave, Suite 104
Phoenix, Arizona 85007

See the video on how to file a licensure complaint

**While it is possible to file a complaint against both licensed and unlicensed interpreters, please be advised that the procedures vary slightly. This video references only complaint procedures related to licensed interpreters. For questions regarding complaint procedures related to unlicensed interpreters, please contact Emmett Hassen at e.hassen@acdhh.az.gov

Code of Professional Conduct

Fields marked with * are required.

1. Type of complaint

Is this complaint for?: *

Licensed Interpreter
Unlicensed Interpreter
Inquiries only

2. Information about you

Name: *

Address:

City:

Zip:

County:

Telephone - Day:

Telephone - Evening:

Email address: *

3. Information on the person(s) you are complaining about

Interpreter Name: *

Profession:

Telephone:

Place incident(s) occurred:

Interpreter Address:

Interpreter City:

Interpreter Zip:

Interpreter County:

Complaint: *

Describe your complaint here. Be specific. What happened? When? Where? Please read instructions carefully before describing your complaint.

Name and phone number of persons who may provide additional information

Name 1:

Telephone 1:

Type of Information 1:

Additional witness? Click "Add" button below to add another person.

4. Other Information

Have you made a direct complaint to the provider of this service?: *

Yes
No

Have you complained to any other person or organization about the service?:

Yes
No

5. Additional Information

You can send your video file to us with this form. If you have any papers which may support your complaint, such as correspondences, please attach copies. You can attach more than one. Do not send originals. If you have physical evidence, it is important for you to retain that evidence in its original condition.

Files:

If the video file size is greater than 5MB, please use https://wetransfer.com and email it to "e.hassen@acdhh.az.gov"

Signature: *

To the best of my knowledge, the information in this complaint is true and complete.

6. AUTHORIZATION

I request and authorize the below-named licensed professional or practitioner and/or any other licensed professional or practitioner, and the below named interpreter, organization or facility and/or any other organization or facility, to disclose fully to the Arizona Commission for the Deaf and Hard of Hearing and its authorized representatives all information and records relating to the incident(s) that occurred for and/or on my behalf, by the said licensed professional, practitioner, organization, or facility.

Your Name: *

Name of practitioner(s): *

Name of Organization/Facility:

Your Signature: *

Recaptcha: *

File a Complaint

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