Division of Disabilities (DDD) Complaint Form

Thank you for reaching out to the Division of Developmental Disabilities (DDD) regarding a concern you have about DDD services and supports for people with intellectual and developmental disabilities. Please fill out the boxes below with as much information as possible so that DDD staff can reach out to you to address your concerns. You should expect to hear from a DDD staff person within 72 hours of your submission. This complaint form is specific to DDD intellectual and developmental disability services only and cannot address general disability or Medicaid related concerns. Abuse and neglect concerns should be immediately reported to Illinois Department of Human Services Office of Inspector General (IDHS OIG) using the 24 hour hotline at 1 (800) 368-1463.

For more information regarding complaint process, please review Filing Complaints About DD Services.

Name of person completing this form:

Phone number:

Email address:

Address:

City, State, ZIP:

Complaint type: General complaint Complaint related to the Home and Community Based Services (HCBS) Settings Rule specifically

Incident Information

Who is the individual involved with this complaint:

Their date of birth (if known):

Their service provider (if known):

Address of site (if known):

City, State, ZIP:

Date of Incident:

Time of Incident:

Names of Anyone Present (witnesses or otherwise):

Please enter the details of the complaint or issue using as much detail as possible. Please include date of occurrence, time of occurrence, location details, names of anyone present (witnesses or otherwise), and a thorough description of what happened. Contact information of other individuals related to the incident are sometimes helpful and should be included if available: