Arizona Department of Health Services

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    Dispensary Complaint Form

    The Medical Marijuana Program provides this Dispensary Complaint Form which allows anyone with knowledge or concerns about a suspected violation to submit a complaint by using this form. A complaint is a suspected violation of Arizona state rules and/or statutes governing the operations of licensed nonprofit medical marijuana dispensaries.

    When filling out this form, information that is required is indicated by a red asterisk (*). Please note that as per A.A.C. R9-17-309(C), the Arizona Department of Health Services shall not accept allegations of a dispensary’s noncompliance from an anonymous source.


    Complaint Information


    Complaint Source*





    Dispensary Information


    Complaint Description



    Evidence*
    Are you aware of any evidence? If yes, describe the evidence.


    Dispensary Notification*
    Has the licensee(s)/owner(s) and/or manager(s) of the dispensary been contacted? If yes, what was the result?


    Law Enforcement Notification
    Have other agencies (i.e law enforcement) been contacted? If yes, which agenc(ies) and what was the result?*


    Submit Complaint
    Online Dispensary Complaint Submission
     
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    Online Dispensary Complaint Submission
     
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