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Grievances and Comments

If you have any comments or grievances regarding the offices and services offered by URWell, please use the form below.

Please note: Do not use this form to communicate any clinical concerns or medical questions. Instead, please contact our offices to schedule an appointment.

Select an office:

*Name:

Campus Address:

*Phone:

*Email:

Date of occurrence (if applicable):

*Description:

Follow-up:
I would like to submit this grievance or comment, and wish to be contacted by URWell.
I would like to submit this grievance or comment, but have no need to be contacted by URWell.

Please be advised that this grievance or comment will be acknowledged and follow-up will occur with all involved.

Procedures for Grievances or Comments

The individual with the grievance or comment either completes a suggestion form or communicates the issue by other means (e.g. email, in-person) to URWell. Once the grievance or comment has been communicated, a period of time may occur for further investigation, regardless of the nature or content of the issue.

URWell may again contact the person initiating the action to clarify or gather more detail. URWell will strive to resolve any grievances brought to its attention, but it should be known that a final resolution may or may not occur depending upon the circumstances and/or situation.

After the investigation is complete, URWell will ensure follow-up with all parties involved. All information will be documented and kept confidential.