505-465-3060

Santo Domingo Health Center

Healthy People, Healthy Community, Healthy Lifestyle

 

Patient Complaint/Grievance Resolution (PCGR) Form

We are listening! Please take a moment to let us know what happened. Your concerns are very inportant to us and we address each response.

Name:

Address:

Phone:

Please check the option(s) below which best provide a general description of the grievance reported. 

 

 

Please provide an objective account of your observations regarding this grievance.

Do you request a follow-up response? Yes No