A printable version in English / Spanish of this form is also available to fax or mail to the DTC Consumer Division.

Please complete the following complaint form as accurately as possible. This information is very important to record your complaint in our system and to help us respond to you. Some fields must be completed in order to process your complaint (* denotes a required field). All information provided on this complaint form may be forwarded to your service provider in an attempt to resolve your concerns.

If you are not the Account Holder, you must complete the Advocate Information Section and provide us with authorization to confirm that you have permission to file a complaint on behalf of the Account Holder. Without this authorization, we are unable to initiate an investigation.

If you are having trouble completing this complaint form, or to schedule an appointment for an in-person intake at our Boston office Monday to Friday from 9am to 5pm, please contact the DTC Consumer Division:

Phone: 617-305-3531 or 1-800-392-6066 (toll free)
Fax:     617-988-8288
Email: consumer.complaints@mass.gov
Mail:    1000 Washington Street, Suite 600
            Boston, MA 02118