Home


Filing A Complaint Against An Abortion Clinic

Understanding The Forms

Get The Forms

The Allegation Form
This provides the department with the basic information needed to determine if the allegation falls under the scope of this department.

The Treatment Data Form
Provides the department with the information needed to subpoena treatment records should the matter progress to that level. This information should include any health care providers you saw or consulted with in regard to your situation.

The Authorization for Release of Information Form
This form is required for the department to obtain copies of your treatment records. A separate form MUST be completed for each health care provider involved with care and/or treatment. It is necessary for a witness to also sign these release forms.

Once completed, all forms may be faxed or mailed to:

Bureau of Health Professions, Complaint & Allegation Division
P.O. Box 30670
Lansing, MI 48909-8170
Fax (517) 241-2389

Get The Forms

© RIGHT TO LIFE OF MICHIGAN, 2340 PORTER ST SW, PO BOX 901, GRAND RAPIDS, MI 49509-0901, (616) 532-2300
PRIVACY POLICY