Health Center Patient Grievance Form
Respect for human dignity includes respecting our rights as a patient at Mazzoni Center. If you feel that any of your rights may have been violated, you may initiate a formal grievance.
The Practice Supervisor or Director of Practice Management will contact you upon receipt of the grievance and will investigate the complaint.
Every effort will be made to respond to the Patient Grievance within 7 business days.
If the complaint will not be resolved, or if the investigation is not or will not be completed within 7 business days, an update will be given to the patient or the patient’s representative informing them that Mazzoni Center is continuing to resolve and investigate the complaint.
Confirm You are Filing a Grievance
I am a Patient of Mazzoni Center and I am Filling a formal grievance