Privacy Complaint Form

  • Please use this form to submit a complaint concerning the privacy and confidentiality of patient protected health information.

    All complaints must be submitted in writing. You will not be penalized or retaliated against in any way for making a complaint to Dr Tracey Williams Dental Office.

    Mail your completed form to :

    Tracey Williams DMD
    303 N Alabama St Suite 270
    Indianapolis IN 46204

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