Client Complaint/Grievance -Hidden Page

Full Name(Required)

DOB:(Required)

Full Address(Required)

Phone(Required)

Email(Required)

Preferred Contact(Required)

Phone

Other

Nature of Complaint/Grievance(Required)

Please describe your complaint or grievance in detail, include: dates, times, specific concerns, and staff/persons involved.

How has this issue affected you or your treatment?(Required)

What steps have you already taken to resolve this issue?(Required)

Please describe how you would like this issue to be resolved(Required)

Thank you for bringing this to our attention. We value your feedback and are committed to providing the best possible care.

Phone

This field is for validation purposes and should be left unchanged.

120 Sister Pierre Dr., #205
Townson, Maryland 21204

443-288-0098

2519 Maryland Ave. Ste. 100
Baltimore, MD 21218

443-288-0098

8:00 AM - 8:00 PM

8:00 AM - 8:00 PM

8:00 AM - 8:00 PM

8:00 AM - 8:00 PM

8:00 AM - 8:00 PM

8:00 AM - 8:00 PM

CLOSED