Grievance/Appeal Forms Request

BHU Grievance/Appeal Forms Request

FOR PROVIDERS: Providers are required to have grievance/appeal forms accessible to clients. Please provide your information and expect your request to be processed within 3-5 business days. Thank you!

"*" indicates required fields

X/Twitter

This field is for validation purposes and should be left unchanged.

Provider Point of Contact:*

First Last

Provider Name*

Provider Address*

City/Town*

State*

State (we can only mail in California)*

ZIP/Postal Code*

ZIP*

Provider Email*

How many ENGLISH grievance/appeal forms are you requesting?*

25

50

75

100

None

Additional forms in other languages (multiple options can be selected)

Spanish

Arabic

Tagalog

Farsi

Vietnamese

Please type in how many of each language:

How many Self-Stamped Envelopes?*

25

50

75

100

None

VISIT ONE OF OUR OFFICES
Southeast San Diego
Midtown San Diego
North County San Diego
Open M-F 9:00 am - 5:00 pm

CALL US
For legal help: 1-877-534-2524
For health related issues: 1-877-734-3258
TTY: 1-800-735-2929

FOLLOW US
dashicons-facebook-alt dashicons-instagram dashicons-linkedin dashicons-youtube

#JusticeBeginsHere

Legal Aid Society of San Diego is a 501(c)(3) nonprofit recognized by the IRS. Tax identification number: 95-1869806

GET UPDATES FROM LEGAL AID SOCIETY OF SAN DIEGO
Keep up to date about our work and how you can help.

Sign Up

Privacy Policy | Terms & Conditions | Web Accessibility | Site Map

PLEASE NOTE: LASSD is moving! Our Southeast San Diego office will be closed to the public starting Thursday, January 15, 2026. We remain open and committed to serving our clients and community throughout all of San Diego County, and can still be reached through our other 2 offices, hotline and website, as well as our various clinics: Contact Us