Tell Your Story Please enable JavaScript in your browser to complete this form.Since the Affiliation have you been able to see your doctors or visit your Specialty Clinic at UTMC?(no selection)YesNoSince the Affiliation has your care cost more?(no selection)YesNoSince the Affiliation has your care been harder to access?(no selection)YesNoSince the Affiliation has your job been moved to ProMedica?(no selection)YesNoSince the Affiliation has your practice been moved against your will?(no selection)YesNoSince the Affiliation has your practice been financially effected?(no selection)YesNoSince the Affiliation are you aware of patient dumping? (no selection)YesNoSince the Affiliation are you aware of UTMC patients being funneled to ProMedica Facilities?(no selection)YesNoTell Your Story Here:We are gathering this information to pass on to law enforcement. You information may be reviewed by an attorney. Your information will otherwise be kept confidential. NameFirstLastEmailPhone NumberPhoneSubmit