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About Us
Service Areas
North Alberta Zone
Central Alberta Zone
Edmonton Zone
News and Events
Community Engagement
Feedback
Contact Us
FEEDBACK
PUblic Feedback Form
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Staff Feedback
Name
(Required)
First
Last
Classification - Choose
(Required)
Patient
Family Member of Patient
Friend of Patient
Other - Explain
Contact Number
(Required)
Please Explain
(Required)
Location of Incident (Zone)
(Required)
North Zone
Edmonton Zone
Central Zone
Calgary Zone
South Zone
Type of Feedback
(Required)
Compliment for Staff
Suggestion for Improvement
Concern About Care Received
Feedback Description
(Required)
HIA/FOIP statement
(Required)
I have read the HIA/FOIP Statement.
Personal or health information collected will only be used for the purpose of tracking, follow up, communications and trending regarding your health experience concern. Information is collected pursuant to section 33 of the Freedom of Information and Protection of Privacy Act (FOIP) and under the authority of Section 20(b) of the Health Information Act (HIA) for the purpose of administering AHS' patient complaint and feedback program.
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