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, please contact the DTC Consumer Division:
Phone: 617-305-3531 or 1-800-392-6066 (toll free)
Mail: 1000 Washington Street, Suite 820
Boston, MA 02118