Form Center

By signing in or creating an account, some fields will auto-populate with your information.

Compliment / Complaint Form

  1. This form is for the Chesapeake Integrated Behavioral Healthcare (CIBH) only. To share a compliment/complaint about another City of Chesapeake Department, please call 757-382-2489.

    The City of Chesapeake is committed to providing the best possible service to our customers. In the event you feel that Chesapeake Integrated Behavioral Healthcare (CIBH) may have exceeded your expectations or that we may have failed to meet our professional standard, please file a customer compliment/complaint using this form or by calling the Client Rights Advocate at 757-547-9334. CIBH will not use email to respond to questions that involve personally identifiable health information, so please include a phone number where we can reach you to discuss your specific situation. We will use email to answer general questions and to provide links to more information.

  2. I understand this Compliment/Complaint Form is for Chesapeake Integrated Behavioral Healthcare (CIBH) only. For other departments, please call 757-382-2489.*
  3. Your Contact Information
  4. Type:
  5. Would you like a follow-up call regarding this comment?
  6. Leave This Blank:

  7. This field is not part of the form submission.