Online Complaint Form

Please complete each section of this online complaint form as you are able. If at anytime you should have questions about this form or are unable to complete it unassisted, please contact our Administrator at 1-800-858-9250.

Complaint Information

When submitting a complaint to Restore Home Healthcare of Oklahoma, you may either provide your name and contact information or submit your complaint anonymously. Providing your contact information enables Restore Home Healthcare to inform you about the actions taken in response to your complaint, and also to contact you should additional information be needed.

It is our policy to treat your name as confidential information and not disclose it to any other party. However, it may be neccessary to share the complaint with the person(s) in the the course of a complaint evaluation.

Restore Home Healthcare forbids anyone in its organization from taking retaliatory actions against anyone, including other employees, clients, client’s family/significant others, coordinated healthcare partners, and/or referring agencies/individuals for having reported quality of care concerns.