Feedback Form

Share a compliment or raise a concern

If you are not comfortable providing personal information regarding yourself or your loved one through this form, please call the Patient Relations office at the number below.

Unity Health Patient Relations (this includes St. Joseph’s Health Centre, St. Michael’s Hospital and Providence Healthcare): 416-864-5215

Where was your Experience(Required)

Providence Health Care
St. Michael’s Hospital
St. Joseph’s Health Centre

Your Feedback(Required)

Compliment
Concern
Suggestion/Comment

Your Name

First Last

Patient's Name

First Last

Patient's Date of Birth

Would you like Patient Relations to contact you(Required)

Yes
No, I don’t require a response

How would you like us to contact you?(Required)

Telephone
Email

Your Phone Number(Required)

Your Email Address(Required)

Tell us about your experience(Required)

If you have requested a response, Patient Relations will contact you within 1-2 business days to acknowledge your feedback and discuss next steps. Please note that the Patient Relations office is open Monday to Friday between 8:30 am and 4:30 pm.

Please do not use this form for medical emergencies. If you need immediate medical assistance, please reach out to emergency services.

By providing an email address in this form, you consent to receive email response from the hospital. There are common risks to using email, as email could be read or saved by someone unintended, or by a service provider (e.g. Rogers, Gmail, etc.).

If you are not comfortable being contacted via email, please do not provide us your email address.

Phone

This field is for validation purposes and should be left unchanged.