Online Complaint Form

If you have a complaint, please take the time to fill out the form below. Here at Help at Home, we care for every client, employee, and anyone else affected by our business. Every complaint is taken very seriously and we will do everything in our power to resolve any problems you may be experiencing.


Your Name :

Address:

City:

State:

Zip Code :

County:

Primary Phone #:

Secondary Phone # (cell):

Email:

Please describe your complaint in full detail.

(Please include as much detailed information as possible including specific names, dates, and locations.)