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Examination Experience Complaint

If your examination experience was less than ideal, staff in the DIFS Insurance Licensing Section would like to know.  Please complete the FIS 2275 Examination Experience Complaint form and submit it to us within 15 days of testing.

The form is an Adobe Acrobat file (pdf) with fillable fields.  When the form opens, select “File > Save As” to save the file on your computer.  To accomplish this successfully, you will need Adobe Acrobat Reader X (10) or a more recent version of Adobe software.

Complete all your contact information at the top of the form.  Click the check box next to the name of the appropriate exam.  In the section labeled “Details of Complaint,” provide information regarding your experience.  

When the form is complete, you will need to print, sign and date the form.  An original signature and date are required; these two areas of the form do not contain fillable fields.

The completed form may be sent to our staff via mail, fax or email as indicated at the bottom of the form.