Patient Complaint or Concern

At Toronto Western Family Health Team, we are committed to ensuring that you have the best possible experience, from booking your appointment to visiting your health care provider and then follow-up. We value your feedback! If you experience a problem, or have a compliment, we would like to know.

Your First and Last Name

Your Address (Street, City and Postal Code)

Your Email

Best phone number to reach you at

Patient Name & Address (if other than the person registering complaint)

Details of compliment or concern. Please describe in as much detail as possible including date of occurrence.

Name of health care team member(s) involved

Describe any efforts that you have made to resolve this matter

Please describe the result or outcome that you would like to see

Any other comments?

Do you consider this matter to be urgent?

Yes No