The University of Texas
Dental Branch at Houston A Part of The University of Texas Health Science Center at Houston

Quality Assurance & Risk Management Concern/Compliment Process & Form

The Dental Branch has a mechanism for responding to patient, visitor, student, staff, and faculty concerns or complaints that require attention at the administrative level. When these situations arise, the individual making the report is asked to complete the "UTDB Quality Assurance and Risk Management Concern Form" and return it to the Director of QA&RM. The matter will be reviewed and every attempt will be made to respond within two weeks of receipt of the form.

Concerns/Compliments are categorized on the form in the following manner:
• Timeliness of care
• Quality of clinical care
• Quality of service
• Infection control
• Communication/behavior
• Professionalism
• Financial

Comments are strongly encouraged to facilitate the review and resolution process.

Concern/Compliment Form