Compliments and Comments

We want to hear from you!

Thank you for choosing Desert Senita as your healthcare provider. We are honored to serve you and your family.

If you have a suggestion or concern that you would like for us to review, please complete this form:

Date
MM slash DD slash YYYY
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone (No International Phone Numbers)
Email
Comment / Compliment
How do you believe we could solve this situation?
Would you like to speak to a manager?
- Yes
- No
When is a good time to contact you?
Name
This field is for validation purposes and should be left unchanged.

If you wish to print the form:

You may hand it to a staff member and ask them to submit, or
You may mail it to us at: Desert Senita Community Health Center, Quality Improvement, 410 Malacate Street, Ajo, Arizona, 85321, or
Email to: pei@desertsenita.org

If after working with our Health Center Staff, your concern has not been resolved and you wish to submit a report, please visit Lighthouse Services or call (855) 400-6002.

Compliments and Comments

Proud Partners