A Seventh-day Adventist Organization

Share Your Story

Sharing your story with us helps us serve you better and provides valuable feedback for our care providers. Your experience at our clinic matters to us and we want to make sure that you are getting the care that you need.

The contents on this form may be used in future marketing materials.

Contact Faculty Dental Practices

Please tell us about your experience. If you are willing to be contacted about your experience, please include your contact information in the provided fields. However, if you wish to remain anonymous, the contact information is not required to submit this form.

 

BY SUBMITTING THIS FORM:I acknowledge that I am voluntarily providing my personal information to Loma Linda University Health. I understand that in order to keep my health information private, I will abstain from using this form to provide details about my medical condition or that of the individual I am requesting information for. I will limit the amount of information shared on this form to only my contact information in order to receive the requested information. I understand that I may contact Loma Linda University Health directly at 855-558-1100 in case I need to discuss confidential or private information. I further understand that I may be contacted by a representative from LLUH in response to my inquiry via telephone or mail. I understand LLUH will not respond via email when communicating confidential or private information.

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