Today is

Online Complaint Form

TO: Mississippi State Board of Funeral Service 3010 Lakeland Cove, Suite W Flowood, MS 39232-9709 Phone: (601) 932-1973 Fax: (601) 932-1901 CONSUMER: Name:   Address:   City, State Zip: Select Alabama Alaska Arkansas Arizona California Colorado Connecticut Washington, DC Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming   Home Phone:   Work Phone:     DETAILS OF COMPLAINT: (Funeral Home, Crematory or Person complained about)   Name:   Address:   City, State Zip: Select Alabama Alaska Arkansas Arizona California Colorado Connecticut Washington, DC Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming   Phone:     Have you complained directly to this business? Yes No Name of person contacted: Date Contacted:               yyyy-mm-dd     DESCRIPTION OF PROBLEM OR COMPLAINT: (Give complete details. Scanned copies of contracts, receipts, canceled checks, or other pertinent documents to include all communications with the funeral home or crematory representatives can be emailed by clicking here or you can mail COPIES ONLY to the address above.)     WHAT ACTION WILL RESOLVE THIS MATTER? Be advised that your identity could be disclosed to the funeral home/crematory/person. The Board's policy is that anonymous complaints will not be processed. I understand that if no applicable regulatory law, rule, regulation or policy has been broken by the business complained of, I will be advised that this is a civil dispute between me and the said business and that I can seek such civil remedy through the courts as appears appropriate to me or my attorney. .         I understand that if the Board feels that there is sufficient evidence to warrant a hearing, I WILL BE REQUIRED TO ATTEND. I agree to attend. Enter this security code in the box below: