Illinois Department on Aging Office of Adult Protective Services Complaint Portal

Illinois Department on Aging Office of Adult Protective Services Complaint Portal

Do not submit potential Adult Protective Services Intakes via this complaint portal.

If you would like to file an APS report, please call 1-866-800-1409

Date of Complaint Submission*

Name of Submitter*

Submitter Email Address*

Submitter Phone Number*

Submitter Address 1*

Submitter Address 2*

Submitter Address 3*

Complaint Response Preference*

Select

Person(s) against whom you are complaining:*

Subject Affiliation*

Select

Agency Name*

Previous Complaint Filed on this Subject?*

Select

Client Name (If Applicable)

Client Date of Birth (If Applicable)

Complaint Narrative*

Please provide a thorough account of the actions against the individual being reported including dates, names, and any relevant information

Others who may have witnessed actions

Please include name and contact information for each, if applicable.

Please include any relevant files:

Drag and drop files here or

Send me a copy of my responses

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