OIG Form Submission - Success Thank you for your submission. OIG Form Submission - Failed The file you were trying to attach was over 25 MB. Please try again. OIG Form Submission - Form Validation Error The form was not submitted because all input fields were left blank. Who's Involved?: Employee Affiliate Facility Vendor Other Please provide names, titles, and contact information of persons involved and any witnesses, if known. What Happened?: Describe what happened and how you know (personal observation, heard from another person). Where?: Please Select Central Office Correctional Health Services Bellevue Belvis (Gotham Health) Carter Coler Coney Island Cumberland (Gotham Health) East New York (Gotham Health) Elmhurst Gouverneur Gouverneur (Gotham Health) Harlem Home and Health Care Jacobi Kings County Lincoln McKinney MetroPlus Metropolitan Morrisania (Gotham Health) North Central Bronx Other Queens Sea View Sydenham (Gotham Health) Vanderbilt (Gotham Health) Woodhull When?: Please specify dates, times, and frequency, if known. Previous Reports: Please include details about any previous reports of this incident made to any other persons/departments. Additional Details: Please provide any other information you believe is important. Attachments (optional): Please upload any evidence that may support your complaint (images, audio, video, documents, etc.) and describe the evidence that you are providing. (File size limit: 25 MB) Contact Information: First Name (optional): Last Name (optional): Email (optional): Telephone (optional): Reports may be made anonymously. However, by disclosing your identity and contact information, you help to expedite the resolution of your complaint by making it easier for the OIG to contact you to answer any follow-up questions. The OIG will respect any requests for confidentiality.