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DECAL Fraud Reporting Form

Please use this form to report suspected fraud. You can report any potential wrongdoing by a client, provider, contractor, or State of Georgia employee related to any DECAL program.

This form should not be used to report general policy violations or complaints about a program. If you need to report violations, make a complaint, or request general information about a DECAL program, contact the appropriate division: https://www.decal.ga.gov/Bfts/ContactList.aspx

Incomplete details or lack of contact information may result in delayed response time or inaction. DECAL will not provide you with status updates or action taken on an allegation.

Please complete the information below, then click Submit.

* indicates required fields.

Who committed the potential wrongdoing? Identify the name of the person and/or organization. Please complete as much information as possible.

Please attach any supporting documents and click Save before submitting the allegation.

If you have any Supporting Documentation (e.g. correspondence, invoice), please attach the file(s)

Note : The following types of documents are valid to upload on this page: PDF, JPG, JPEG, GIF, PNG, BMP, TIF, TIFF, PIC, XLSX, DOC, DOCX, CSV, TXT.

Reporting Information: Sharing your contact information is critically important to us and can help the investigation. NOTE: The lack of valid contact information may prevent a comprehensive review of the complaint.

Internal Use Only

This section is only intended for Internal Use only (DECAL Staff).

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