State of Ohio Board of Pharmacy Complaint Form

Items marked with a * are required.

Is your complaint against a business such as a pharmacy or hospital?*

Is your complaint against a person, such as a pharmacist, pharmacy technician, patient or prescriber?*

Does your complaint involve a specific prescription?*

Does your complaint involve an OARRS report?*

Have you made a complaint to any other government agency, professional association, etc. about this matter?*

In your own words, with as much detail as possible, please state your complaint.*

Maximum 8000 characters

Were there any other witnesses or other persons who may have additional information about your complaint?*