Housing Support Complaint Form

Reporter information
This form is to be completed only if you have a complaint or concern about Housing Support settings and services (i.e., long-term homeless supportive housing, board and lodges, etc.)
Name
Phone
Area CodePhone Number
Provider Information
Provider Name
Provider City
Provider Phone
Area CodePhone Number
Who is the subject of the report?
Please Describe what happened?
Has this been reported to the Minnesota Adult Abuse Reporting Center (MAARC)?

yes
no
Would you like a copy of this email?

yes
no

Reporter information