Compliance Concern Form
KDMC is committed to providing quality care to our patients while maintaining
practices and programs that are consistent with the laws and regulations
that govern our work. The Compliance Concern Form (CCF) is an online tool
for you to communicate any question or concern to the KDMC Corporate Compliance
Officer for further investigation.
Please complete the form below providing all relevant information with
as much detail as possible. You may choose to remain anonymous; however,
anonymity may hinder our ability to follow-up with your concern or question.
This submission will be reviewed within 14 days of receipt. If you provide
contact information, you will be contacted with follow-up information.
Please contact Paula Willis (606-408-0161), Corporate Compliance Officer, at
email@example.com or Mona Thompson (606-408-4496), Vice President/Chief Compliance Officer, at
You also may report anonymously through the Corporate Compliance Hotline:
606.408.4145 or 1.877.327.4145.