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Oklahoma State Board of Examiners for Long Term Care Administrators
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* Integrity * Service * Professionalism * OSBELTCA * / File Complaint
Welcome to the LTC Administrator Complaint Registry



REPORT AN ADMINISTRATOR ONLINE
Information identifying the Long Term Care Administrator against whom the report is being filed:


AsterikIndicates Required Fields

Asterik Last Name:
Asterik First Name:
Asterik Name of Facility:
Asterik City:
Asterik Nature of Your Report (be as specific as possible, including names, dates, etc., and cite the rule number(s) from OAC 490:10-5-3(a) that you believe the administrator most likely violated):
10000 Characters remaining

Information identifying the individual filing the report: (NOTE: The Board cannot accept or process 'anonymous' reports. If the information requested below is not furnished, the Board cannot and will not proceed.)

Asterik Last Name:
Asterik First Name:
Asterik Phone: e.g., (555-222-1111)
Asterik Street:
Asterik City:
Asterik State:
Asterik Zip:
Asterik Email Address:


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