Westchester Medical Center Specialty Pharmacy Patient Complaint & Recommendation Form

Westchester Medical Center Specialty Pharmacy
Patient Complaint & Recommendation Form

Patients have the right to express concerns, file grievances, and recommend improvements. All documented complaints will be investigated, and a response will be provided within five (5) business days.

Patient Information

First Name

Last Name

Date

Street Address

City

State

Zip Code

Phone

Description of Complaint and/or Recommendation

Please include dates, staff involved (if known), and relevant details.