Sandhills Center Consumer Concerns, Complaints, Compliments Form

If you have a concern, complaint, or compliment related to services under the direction of Sandhills Center we would like hear from you.

We ask that you speak directly to a member of our staff, contact our Director of Consumer Affairs, or complete this form and forward it to us.

Consumer

Concerns, Complaints, Compliments

Name: _______________________________________________ Date: ____________________________

Address: _______________________________________________________________________________
Street City State Zip Code

Would you like to be called? Yes ___ No ____ If so, when/where is the best time to reach you?

_______________________________________________________________________________________

Telephone number where you can be reached ________________________

1. What is your concern, complaint, or compliment related to services under the direction of Sandhills Center ?

_______________________________________________________________________________________

2. How have you attempted to resolve this concern or complaint?

_______________________________________________________________________________________

3. What outcome would you like to see regarding this matter?

_______________________________________________________________________________________

Please forward this completed form to:
Mike Markoff, Consumer Affairs Director
P.O. Box 9 West End, NC 27376
mikem@sandhillscenter.org
Telephone: 910-673-5631 ext. 312 or 1-877-906-4745 (toll free)