At Ryan White Services and Resources (RWSR), we are committed to providing high-quality care and support for individuals living with HIV. We recognize that there may be times when our services do not meet your expectations or when challenges arise in accessing care. To ensure that we continually improve our programs and address any concerns, we encourage you to report any grievances you may have experienced.
This Grievance Reporting Form is designed to gather information about issues related to our services. Your feedback is invaluable in helping us understand the impact of these challenges and identifying areas for improvement. Please take a moment to share your experience with us. All submissions will be treated with strict confidentiality, and you have the option to remain anonymous.
Thank you for your participation in helping us enhance the quality of care for our community.
RWSR Grievance Policy for Ryan White Part A Program
RWSR Grievance Reporting Form
Purpose: This form allows individuals to report grievances related to services provided by the Ryan White HIV/AIDS Program. Your feedback is essential for improving the quality of care and support offered to People Living with HIV (PLWH) in our community.
Confidentiality: Any information provided will be kept confidential. Please do not include protected health information (e.g., medical records, diagnosis, treatment), unless you are the individual affected and consent to self-disclose for follow-up purposes.
Thank you for taking the time to share your experience.
Disclaimer: RWSR is a HIPAA-covered entity and is subject to privacy and security regulations.