Please enable JavaScript in your browser to complete this form.
Patient Suggestion Form
Back To Home
Please enable JavaScript in your browser to complete this form.
Please Select The Clinic You Visited Today
96 West
CHCL Main Clinic
Arnett Benson Medical and Dental
Chatman Clinic
Community Dental Clinic
Medical Office Plaza
Parkway Clinic
West Medical and Dental Clinic
Please tell us what you enjoyed about the care you received
Please tell us what you would like to see changed so that we may better serve you.
Please do not include any personal information such as SSN, MRN, Credit Card Numbers on any of our forms.
Comment
Submit
English
Arabic
Chinese (Simplified)
English
Filipino
Finnish
French
German
Italian
Japanese
Portuguese
Russian
Spanish
Vietnamese
Request Appointment
Follow Us On Facebook
Home
About Us
Our History
Community Partners
Services
Patient Information
New Patient Information
Patient Resources and Information
Patient Notices
Locations and Hours
96 West
CHCL Main Clinic – Lubbock Clinic
Arnett Benson Medical and Dental Clinic
Chatman Clinic
Community Dental Clinic
Mobile Medical and Dental Unit
Medical Office Plaza
Parkway Clinic
West Medical and Dental Clinic
Contact Us
Employment
English
Arabic
Chinese (Simplified)
Filipino
Finnish
French
German
Italian
Japanese
Portuguese
Russian
Spanish
Vietnamese