patient complaint form samples

Every patient deserves to be treated with the right amount of respect and with the kind of care that they deserve. Hospitals have tons of patients every single day, and it’s their job to make sure that each and every one of their patients is well taken care of and that they’re given top-quality treatment.

Unfortunately, there are those hospitals that fail to do just that. There are those hospitals whose patients feel that they weren’t given the proper treatment, especially not with the amount of money they paid for. So how would these patients go about airing their grievances?

Fortunately for them, there are Patient Complaint Forms available here for easy download.

Medicare Quality Complaint Form

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  • PDF

Size: 38 KB

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Free Patient Complaint Form

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  • PDF

Size: 97 KB

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Patient Complaint Form Sample

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  • PDF

Size: 72 KB

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Patient Privacy Complaint Form

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  • PDF

Size: 49 KB

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The Different Kinds of Patient Complaint Forms

There are various types of Patient Complaint Forms that people can use when they’re experiencing unbearable service, or if they know another patient who’s going through such an ordeal. Here are some examples of these kinds of forms:

  • Medicare Quality Complaint Forms are forms that are used by those patients suffering from certain disabilities that require constant attending to. These forms are used when those patients who are getting such treatment feel as if the quality of their treatment is not what was expected or agreed upon.
  • Patient Privacy Complaint Forms are for those patients who have a complaint with the hospital when it comes to their privacy. These complaints could range from a number of things. It could be that someone was willingly able to enter and exit their rooms without the patient’s consent, or if an outsider was able to take that patient’s confidential information and use it for personal gain.
  • Patient Complaint / Grievance Forms are forms for patients who feel as if there were too many problems in the hospital that made them feel very mistreated. It’s possible these patients took it on a personal level. An example would be that a particular nurse might have been discriminating against a patient for having a different nationality, or if the patient was maltreated altogether by the medical staff.

Patient Complaint/Grievance Form

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  • PDF

Size: 110 KB

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Patient Complaint Report Form

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  • PDF

Size: 66 KB

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Patient Complaint Form Example

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  • PDF

Size: 185 KB

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Patient Complaint Form Format

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File Format
  • PDF

Size: 79 KB

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Basic Patient Complaint Form

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File Format
  • DOC

Size: 4 KB

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The Importance of Having Patient Complaint Forms

It’s really important that these patients have ready access to these Complaint Forms as these may just improve the quality of hospital services. Let’s say, for example, that a sixty-something patient has a certain disability in which he needs to be helped by nurses constantly. None of the nurses gave him the quality care he deserved, hence that patient lets the hospital know about this by filing Medicare Complaint Forms.

These complaints could help patients get the services that they deserve, and it lets hospitals know which aspects they need to improve on. It’s the job of those working at a hospital to make sure that their patients get the very best treatment, and it’s also up to them to make sure that these patients feel safe and secure within their premises.

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