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Online Customer Comment Card

Welcome to RPMH’s online Customer Comment Card. This service is to provide patients and their families an opportunity to comment on the service and staff during their stay and discharge.

Complete the form below and follow the instructions to send your comment. Your comment will not be available for public viewing on this website.

  • Your Customer Comment will be printed and delivered directly to our Quality Improvement Officer.
  • Your comment is NOT confidential. If message contains anything deemed inappropriate, your message will not be delivered.
  • Customer Comments are monitored several times daily.

If you have immediate concerns or unresolved problems please call RPMH Administration at (325) 235-1701 extension 221.

Your First and Last Name:
Street Address:
City, State, Zip:
Your Phone Number:
Your Email Address:
Your comments: