Southwest Washington Medical Center



 
 

Patient Comments

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Every comment we receive helps us provide better care. Thank you for taking the time to share your valuable insights.This form is not secure. Please do not include information such as medical records number, Social Security number, health insurance identification numbers, or similar information.If you prefer to call, call Patient Relations, 360.514.2286.Why do we ask these questions?

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First Name * 
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Last Name * 
Street Address 1 
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Email Address 
Telephone number * 
If you are not the patient, what is the name of the patient? 
Patient's Date of Birth 
I authorize Southwest Washington Medical Center to release information regarding comments to the health care professionals involved in my / the patient's care. All concerns are investigated through our formal grievance process. * 

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