Family and Patient Feedback Form

 The Youth Clinic is committed to providing evidence-based, quality healthcare for every patient. Should you have any questions regarding billing, privacy, and consent laws for both minors and patients 18 and older, or our policy on separations, divorce, and custody matters please let us know.

We are happy to hear your feedback to improve the care we provide. To provide feedback, download this form and return it to any of The Youth Clinic locations.