Complaint Form

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Complaint Form

We take your concerns very seriously. We strive to provide excellence in all aspects of our service provision with respectful and professional clinical and administrative services. If you would like to make a formal complaint regarding the quality or safety of the service provision you or your loved one received through our care, please start by filling out this complaint form.

Please indicate how you would prefer that the complaint be handled:

I would like to be shown actions taken to resolve and prevent the issue(s)

I would like this complaint to be forwarded to OkanaMed's Medical Director

Other:

Please describe in your own words the issue(s) that you encountered:

Please describe how you would like to see these issues improved:

Would you like a personal response from OkanaMed addressing your complaint and the corrective actions taken?

Yes

Clear selection

How would you like your complaint form and/or our response to be sent to you?

Email address

Mailing address

Both

Clear selection

Please provide your email and/or mailing address:

Submit

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