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Anyone with knowledge or concerns about the care of a patient/resident in a licensed healthcare facility may file a complaint with their State Survey Agency. Facility Licensing and Investigation Section (FLIS) is the agency that has regulatory oversight for all the licensed healthcare entities in the state.

You may click this link FLIS Complaint Submission to file a complaint if you are concerned about the health care, treatment, or services that you or another person received or did not receive in the facility. Some reasons for filing a complaint would include abuse, neglect, poor care, not enough staff, unsafe or unsanitary conditions, dietary problems, or mistreatment.

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There are several ways to access your immunization record or show proof you received the COVID-19 Vaccine(s).

The CDC Covid Vaccination Card is given to you from most providers - it is issued by the Centers for Disease Control and Prevention (CDC) and lists: your name, date of birth, how many COVID-19 vaccine doses you received, the date(s) you received the dose(s), and where you received it. Keep your vaccination card in case you need it for future use. You can take a picture of your vaccination card as a backup copy. If you lose the card, contact your vaccination provider to request a copy.
Access your official immunization record through the secure CT WiZ Public Portal. If the public portal link does not locate your record, you can call the DPH Immunization program (860) 509-7929 Monday-Friday 8:30am-4:30pm, or submit a ticket below for additional assistance. Please allow 1-3 business days for processing time.
Or, if you have an account, log into VAMS and View or Download your Certificate of COVID-19 Vaccination

Note: The CDC vaccine card, your provider’s portal record, VAMS certificate, and the CT WiZ official immunization record are all acceptable forms of proof of your COVID-19 vaccination.

Click here for information from the FBI about how it is a crime to make or buy a fake COVID-19 vaccination record card. If you did not receive the vaccine, do not buy fake vaccine cards, do not make your own vaccine cards, and do not fill-in blank vaccination record cards with false information. The unauthorized use of an official government agency's seal (such as HHS or the Centers for Disease Control and Prevention (CDC)) is a crime, and may be punishable under Title 18 United States Code, Section 1017, and other applicable laws.

There are several ways to access your immunization record or show proof you received the COVID-19 Vaccine(s).

The CDC Covid Vaccination Card is given to you from most providers - it is issued by the Centers for Disease Control and Prevention (CDC) and lists: your name, date of birth, how many COVID-19 vaccine doses you received, the date(s) you received the dose(s), and where you received it. Keep your vaccination card in case you need it for future use. You can take a picture of your vaccination card as a backup copy. If you lose the card, contact your vaccination provider to request a copy.
Access your official immunization record through the secure CT WiZ Public Portal. If the public portal link does not locate your record, you can call the DPH Immunization program (860) 509-7929 Monday-Friday 8:30am-4:30pm, or submit a ticket below for additional assistance. Please allow 1-3 business days for processing time.
Or, if you have an account, log into VAMS and View or Download your Certificate of COVID-19 Vaccination

Note: The CDC vaccine card, your provider’s portal record, VAMS certificate, and the CT WiZ official immunization record are all acceptable forms of proof of your COVID-19 vaccination.

Click here for information from the FBI about how it is a crime to make or buy a fake COVID-19 vaccination record card. If you did not receive the vaccine, do not buy fake vaccine cards, do not make your own vaccine cards, and do not fill-in blank vaccination record cards with false information. The unauthorized use of an official government agency's seal (such as HHS or the Centers for Disease Control and Prevention (CDC)) is a crime, and may be punishable under Title 18 United States Code, Section 1017, and other applicable laws.

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Moderna Pfizer Johnson and Johnson *

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Number of Pfizer Doses Wasted: *

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Expiration Date*

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Number of Johnson and Johnson Doses Wasted: *

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Complete this form to request a call-back from your local Community Action Agency (CAA). CAA staff will help you sign up for Water and/or Energy Assistance programs.

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