Provider Complaint Form
The Committee for Oversight of Domestic Violence Offender Intervention Programs and Standards (CODVOIPS) has set procedure for complaints filed against approved providers. Please review the Complaint Policy and the Minimum Standards Manual available at https://icdv.idaho.gov/dv-standards-resources.html before filing a complaint against a CODVOIPS approved provider.
Complaint Made By:
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First Name
Last Name
E-mail
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Phone Number
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Area Code
Phone Number
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Complaint is Against:
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First Name
Last Name
Business Name:
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Phone Number
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Area Code
Phone Number
Email
example@example.com
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Details: Please include a written account of your complaint including dates, times, names of witnesses with addresses, phone numbers, and other relevant information (i.e. police reports filed, licensing bureau complaint filed, etc.) Documentation may be submitted in the field below or by uploading documentation.
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Attach any supporting documentation
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of
Please detail which Minimum Standards for Domestic Violence Offender Intervention were violated.
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This complaint is true, accurate, and complete to the best of my knowledge.
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Date:
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