Common use of Concerns or Complaints Clause in Contracts

Concerns or Complaints. If you are dissatisfied with the services received, you are encouraged to discuss your concerns with your healthcare professional. Your provider will take your concerns seriously and will treat you with care and respect. If you are not satisfied with the resolution, you can contact the California Board of Psychology of the Department of Consumer Affairs at 0000 Xxxx Xxxxxx, Suite 22, Sacramento, California 00000-0000. Or you may reach them at 000-000-0000. By signing below, you acknowledge that you have read and understand the above policies and procedures, and agree to abide by them. Name Name Signature Signature Date Date The Clinic 000 Xxxx Xxxxxx, #368 San Francisco, CA 94117 xxx.xxxxxxxxxxx.xxx PH 000-000-0000

Concerns or Complaints. If you are dissatisfied with the services received, you are encouraged to discuss your concerns with your healthcare professional. Your provider will take your concerns seriously and will treat you with care and respect. If you are not satisfied with the resolution, you can contact the California Board of Psychology of the Department of Consumer Affairs at 0000 Xxxx Xxxxxx, Suite 22, Sacramento, California 00000-0000. Or you may reach them at 000-000-0000. By signing below, you acknowledge that you have read and understand the above policies and procedures, and agree to abide by them. Name Name Signature Signature Date Date The Clinic 000 Xxxx Xxxxxx, #368 San Francisco, CA 94117 xxx.xxxxxxxxxxx.xxx PH Ph 000-000-0000 Fax 000-000-0000

Concerns or Complaints. If you are dissatisfied with the services received, you are encouraged to discuss your concerns with your healthcare professional. Your provider will take your concerns seriously and will treat you with care and respect. If you are not satisfied with the resolution, you can contact the California Board of Psychology of the Department of Consumer Affairs at 0000 Xxxx Xxxxxx, Suite 22, Sacramento, California 00000-0000. Or you may reach them at 000-000-0000. By signing below, you acknowledge that you have read and understand the above policies and procedures, and agree to abide by them. Name Name Signature Signature Date Date The Clinic THE CLINIC 000 Xxxx XxxxxxXXXX XXXXXX, #368 San FranciscoSAN FRANCISCO, CA 94117 xxx.xxxxxxxxxxx.xxx XXX.XXXXXXXXXXX.XXX PH 000-000-0000

Concerns or Complaints. If you are dissatisfied with the services received, you are encouraged to discuss your concerns with your healthcare professional. Your provider will take your concerns seriously and will treat you with care and respect. If you are not satisfied with the resolution, you can contact the California Board of Psychology of the Department of Consumer Affairs at 0000 Xxxx Xxxxxx, Suite 22, Sacramento, California 00000-0000. Or you may reach them at 000-000-0000. By signing below, you acknowledge that you have read and understand the above policies and procedures, and agree to abide by them. Name Name Signature Signature Date Date The Clinic THE CLINIC 000 Xxxx XxxxxxXXXX XXXXXX, #368 San FranciscoSAN FRANCISCO, CA 94117 xxx.xxxxxxxxxxx.xxx XXX.XXXXXXXXXXX.XXX PH 000-000-0000