Patient Feedback Form

 

The Department / Employee / Service in question:   
The date of the incident/occurrance:
The nature of the problem:  
 
Email: patientrelations@wakehealth.edu

If you would like a response, please provide contact information.
This is NOT required.

Your Name
Your Telephone
Your E-mail

 

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Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.