Department of Public Health - Petition Form

Remote Online Notarization (RON)

Knowledge-based Authentication (KBA)

Verification

This form is used to file a complaint regarding the care provided at a Connecticut Healthcare Facility.

Remote Online Notarization (RON)

Knowledge-based Authentication (KBA)

Verification

This form is used to file a complaint regarding the care provided at a Connecticut Healthcare Facility.

Remote Online Notarization (RON)

Knowledge-based Authentication (KBA)

Verification

Cost: $25 + $10 per added notary seal
Avg Notarization Time: Eight minutes

Cost: $25 + $10 per added notary seal
Avg Notarization Time: Eight minutes

Remote Online Notarization (RON)

Knowledge-based Authentication (KBA)

Verification