• Image field 4
  • Please select the region associated with your comment, concern, or inquiry.*
  • Did your concern or complaint occur at any one of our Providence hospitals, or in an Emergency Department (ED) at any one of our Providence hospitals?*
  • Because your experience occurred in a hospital or hospital Emergency Department, it must be reviewed by that hospital’s Patient Relations Department to ensure it reaches the right team quickly.

     

    Please select the hospital where your experience took place for direct contact information:

    Santa Rosa Memorial Hospital — 707-547-4647

    Queen of the Valley Medical Center — 707-252-4411 ext. 2623

    Redwood Memorial Hospital — 707-725-3361

    St. Joseph Hospital Eureka — 707-445-8121

     

    Once you contact the hospital directly, their Patient Relations team will assist you further.

    (If your concern involves outpatient or medical group care, please return to the previous question and select “No” to continue with this form.)

  • Because your experience occurred in a hospital or hospital Emergency Department, it must be reviewed by that hospital’s Patient Relations Department to ensure it reaches the right team quickly.

     

    Please select the hospital where your experience took place for direct contact information:

     

    Cedars-Sinai Tarzana Medical Center - 818-881-0800

    Holy Cross Medical Center - 818-496-4792

    Little Company of Mary Hospital - 310-303-5079

    Mission Hospital Laguna Beach - 818-847-4851

    Mission Hospital Mission Viejo - 949-364-1400 ext 4505

    St. Johns Health Center - 310-829-8478

    St. Joseph Hospital of Orange - 714-771-8000 ext. 11000

    St. Joseph Medical Center Burbank -  818-847-4851

    St. Jude Medical Center - 714-992-3000 ext 3749

    St. Mary’s Medical Center - 714-771-8000 ext 11000

     

    Once you contact the hospital directly, their Patient Relations team or applicable department(s) will assist you further.

    (If your concern involves outpatient or medical group care, please return to the previous question and select “No” to continue with this form.)

  • Image field 6
  • Format: (000) 000-0000.
  • Relationship to Patient*
  • Image field 12
  • Provider's Area of Practice*
  • Image field 17
  • Patient's Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Image field 23
  • Nature of Comment/Concern/Inquiry (Choose all that apply)*
  • Date of Occurrence*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Do you wish to be contacted? If yes, correspondence will be initiated by email and if necessary, a phone call appointment is scheduled*
  • Should be Empty: