Rochester Regional Health

Patient Compliments & Complaints Form

Patient Compliments & Complaints Form It is the goal of Rochester Regional Health to provide high quality care with compassion. We appreciate your feedback! You may securely send us compliments or complaints about the care that you or a loved one received at any Rochester Regional Health location using the form below.

We take your feedback seriously and appreciate the opportunity to learn about what is working well and what improvements need to be made to provide the best possible care and experience to our patients and their loved ones. All submissions will be reviewed carefully and managed through our reporting system, SafeConnect.

If a response is requested, we will contact you directly. If you would like to speak to someone about your feedback, please call the Speak Up We Care Patient Hotline at 585.922.5465.

For general questions and assistance, please use our "Contact Us" page or call us at or call us at 585.922.4000.

Thank you,
Patient Relations Coordinator ( 585.922.2050 )
Speak Up We Care Patient Hotline ( 585.922.5465 )

*required field


Your Information

* Your Name:
* Patient's Name:
(if different from your name)
Patient's Date of Birth:
(format: 00-00-0000)
* Hospital or facility where patient received care?

Date(s) of care:
(please provide the approximate date(s) when the patient received care)


Best Way to Contact You

* Home Phone:
Work Phone:
* Email:

Compliment / Complaint

* Please include your compliment / complaint in the box below. Any details of care / services provided, health care provider names and explanation of your situation will better help us direct your feedback to the appropriate person(s) and follow-up on the information that you have provided.