Please complete this confidential form to request assistance in advocating for yourself or your loved one living who resides in a nursing home or assisted living home. We understand that you may not have access to all the information requested, but please be complete as much as possible. An Ombudsman will contact you if you provide your contact information. You may also file a complaint with the facility's licensing agency, Office of Health Care Quality.
Anne Arundel County, Maryland. 44 Calvert Street, Annapolis, Maryland 21401 | Tele: (410) 222-7000