We want to hear your concerns in your own words and understand how the experience affected you or your loved one. If you would like a copy of your health records, please use this form instead.
If you use AI tools to help with writing, please make sure the wording still reflects your experience. Very long or unclear AI‑generated text can slow down our review and we may need to ask you to resubmit.
Simple, clear language is best. Please explain what happened, the specific questions you want us to answer, and the outcome you’re hoping for.