Contact Us CONTACT USGet in touch Contact - Green Apple Name * First Last * Last Email * Insurance Subject * Message * Submit If you are human, leave this field blank. 1-406-866-0350fax. 406-403-0263greenapplecounseling@gmail.com1219 Central, Great Falls, MT 59401205 Haggerty Suite 150, Bozeman, MT 59715 Grievance Report Grievance Report Name of Grievant Name of Grievant First Name First Name Last Name Last Name Date of Grievence (MM/DD/YYYY) Client of Green Apple Client of Green Apple First Name First Name Last Name Last Name Phone Number Statement of Grievence Relief Sought Request Meeting Yes No Meeting Date (MM/DD/YYYY) Grievance Signatures Grievance Signatures First Name First Name Last Name Last Name Date (MM/DD/YYYY) Recieved by Recieved by First Name First Name Last Name Last Name Date (MM/DD/YYYY) Rectified Grievant Signature Grievant Signature First Name First Name Last Name Last Name Date (MM/DD/YYYY) Green Apple Director Green Apple Director First Name First Name Last Name Last Name Date (MM/DD/YYYY) Submit If you are human, leave this field blank. Green Apple Behavioral Health Customer Satisfaction Survey: Green Apple Behavioral Health Customer Satisfaction Overall, how satisfied or dissatisfied are you with Green Apple Behavioral Health? Very satisfiedSomewhat satisfiedSomewhat dissatisfiedVery dissatisfiedNeither satisfied nor dissatisfied Were you involved in creating your treatment plan? Yes No Were you informed of your rights and the grievance procedure? Yes No What do you like about Green Apple? What improvements could be made? Submit If you are human, leave this field blank.
