Follow the steps to complete the form accurately.

1. Press the ‘Get Form’ button to obtain the form and open it in your chosen editing application.
2. Fill in your personal information in the designated fields, including your name, date of birth, address, and phone number. Ensure that all information is accurate for proper identification.
3. Provide your account number if applicable, along with your city, state, and zip code to complete your contact details.
4. Indicate the provider or clinic you are addressing for your concern or compliment by filling in the necessary field.
5. In the 'Concern/Compliment' section, clearly detail your issue or praise. Use as much space as necessary to articulate your thoughts and experiences.
6. If you have previously discussed your concern with anyone at SSM Health, check the appropriate box and, if applicable, provide their name along with the date of your conversation.
7. Sign and date the form to authenticate your submission. Your signature confirms that the information you've provided is true and accurate.
8. Finally, return the completed form by following the instructions provided for mailing or faxing to the Director of Service Excellence at SSM Health.

Complete the SSM Health Patient Concern/Compliment Form online to ensure your feedback is heard.