Contact Us

We want to hear from you! If you have any questions or comments concerning South Central Kansas Medical Center, our services or this web site, please feel free to contact us.

 

           

123 Street Avenue, City Town, 99999

(123) 555-6789

email@address.com

 

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Exceptional Service Nomination Form

Use this form to recognize staff for going above and beyond! We appreciate your feedback in rewarding those individuals who provide outstanding customer service, exceptional dedication to the team,or high quality patient care.

 

Please complete the section below:

Nominee *
Nominee
Submitted By
Submitted By
May we use your name and comments in promoting the medical center’s services through the use of newspaper, radio, online, and/or other forms of advertising? *