Customer Feedback Name(Required) First Last Phone(Required)Email(Required) Please tell us about your experience as a patient with MPHC. Let us know if there are other services you would like to see added in the future and, if you are a patient receiving the sliding fee discount, if the nominal fee charged has been a barrier to receiving the services you need.(Required)Did you receive the sliding fee?(Required) Yes No At what percent did you receive the sliding fee?(Required) 0% 25% 50% 75% Is the nominal fee charged a barrier to receiving care?(Required) CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
