If you believe you have experienced Medicare fraud, errors, or abuse, please use this form to report it to the Washington State Senior Medicare Patrol.

When making your report, please include your phone number and email and how you would like someone to contact you. Please DO NOT put your Medicare number, Social Security number, or any confidential information in this form. Thank you

  • Current Page 1 - Your information
  • Page 2 - Beneficiary information
  • Page 3 - Fraud information
  • Service provider's information
1 of 4
Indicates required field

Your information

Please supply your preferred contact information below or leave blank if you do not want to be contacted.

How did you learn about reporting fraud?