Patient Feedback

Requests, Suggestions and Complaints

Patients and their relatives can send us requests, suggestions, complaints and thanks through this form. Every submission is given a tracking number.

Applicant * Please select… PatientPatient relativeOther

Type of notification * Please select… RequestSuggestionComplaintThanksInformation request

Full name *

Phone *

Email (optional)

Date of visit or treatment (optional)

Subject *

Your message *

Preferred reply method

Phone Email Either is fine

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