Patient Feedback – Cornerstone RHC

Thanks! Please leave your short recommendation.*
Select "Copy & Next" when done to copy and paste your feedback to sites you select.
Will you spend one minute to help us by rating us on social media?*
- Yes
- No
Name (Optional)
First Last

Name*
First Last
Email
Phone*
Please tell us about your visit and how we can improve.*
Waiver*
I acknowledge that I am not including any protected health information (PHI) in my inquiry. I understand that any such information should be presented in person or securely over the phone with my health care provider. PHI includes, but is not limited to, any information that relates to 1) the past, present, or future physical or mental health or condition of an individual, 2) the provision of health care to an individual or 3) the past, present, or future payment for the provision of health care to an individual that identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual.
- I accept
Name
This field is for validation purposes and should be left unchanged.