OIG Complaint Form

Report Fraud, Waste, Abuse or Corruption Within the Executive Branch of State Government

DO NOT PROVIDE ANY DATES OF BIRTH OR SOCIAL SECURITY NUMBERS ON THIS FORM.

Anonymous Notice

If you are a public employee, you may qualify for whistle blower protection, which will protect your identity from disclosure without your consent unless certain rare exceptions apply. See O.C.G.A. § 45-1-4 for details.

Is your complaint related to the administration of Medicaid or PeachCare for Kids?

Please proceed to: https://dch.georgia.gov/office-inspector-general

Is your complaint related to the administration of the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), or other social service programs under the Division of Family and Children Services (DFCS)?

Please proceed to: https://dhs.georgia.gov/fraud-waste-and-abuse

Are you a State Employee?

What Agency Do/Did you work for?

Do you wish to have your identity protected from disclosure?

First Name

Last Name

Best Contact Phone Number

Please enter the 10-digit phone number (including dashes, 555-555-5555).

Email Address

Note: You will not receive an email with a copy of this complaint. You will receive a confirmation number on the next page once you submit your complaint.

County of Allegation? (If multiple, select best)

Did you file your complaint with another organization?

With what organization was your complaint filed?

Summary of facts

Does the complaint involve a specific individual?

First Name

Last Name

Position / Title

Employer

Street Address

City

State

Zip Code

Name / Contact Info of Additional Individuals

Attach relevant documents

You will be able to submit relevant documents on the next screen. After you submit this complaint, you will receive a confirmation number. You will see the email address to which you can send relevant documents. You will include your confirmation number in the email subject line so your documents will be linked to this complaint.