Advantage Behavioral Health Systems (AHBS) is committed to providing quality services to our clients. All issues will be addressed in a timely manner by professional members of the ABHS team. Please provide the following information to assist us in resolving the issue to your satisfaction. You may return this form to any ABHS employee, place it in the US mail to: ABHS, CQI Department, 250 North Avenue, Athens, GA 30601; or call our toll-free Client Helpline at 1-866-778-ABHS (2247) to discuss the issue and have the Client Issue Resolution Advocate complete the form on your behalf. Thank you for your feedback.

(*) indicates a required field

Name of Client (*)

Please type your full name.
Name of Person Presenting Issue (*)

Type your name here
Relationship to Client

Please type your relationship to the client
Disability Group of Client
Mental Health Development Disability Addictive Disease
Invalid Input
Name of Staff Member(s) and/or Program Involved (*)

Invalid Input
Please describe the issue, giving all facts (*)

Invalid Input
Witnesses or others involved (please name)

Invalid Input
How can our agency help resolve this issue to your satisfaction?

Invalid Input
How should we contact you?
E-mail Phone Mail

E-mail

Invalid email address.
Phone Numbers

Type your phone number
Address (*)

Invalid Input

  


Someone will respond as soon as possible.