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Website Feedback
Website Feedback
Please use this form to report issues, request additions, and request changes/modifications regarding to the new Via Christi website.
The Via Christi Health eHealth department is committed to improving and maintaining our new website. We will promptly address, respond, and seek to repair problems users find anywhere on the site. We also will review and follow up on all new page addition requests, new application requests and general feedback requests in a timely manner.
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Name
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Email Address
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Phone
Type of User
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- Select User Type -
Visitor
Patient
Employee
Other
If Other User Type Please Specify
Type of Request
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- Select Request Type -
Report a problem with the website
Request changes to the website
Request new web pages
General feedback and suggestions
Other
If Other Request Type Please Specify
Location/Department
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Via Christi Health (General, All)
Via Christi Hospitals (Wichita)
Via Christi Rehab Center (Wichita)
Mercy Regional Health Center (Manhattan)
Via Christi Hospital (Pittsburg)
Via Christi Villages
Preferred Health Systems
Other
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Is this a new request or follow up on an existing request?
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New Request
Follow Up Request
Address (ex: www.via-christi.org/body.cfm?id=123) of page(s) this request is about
Description of Request
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