Healthicity Audit and Compliance Solutions

Madison County NY Government

Use this form to report any concerns or incidents related to compliance, privacy, ethics, patient safety, or other potential risks. You may report anonymously or provide your name. Please include as much detail as possible so we can properly assess and address the issue. Fields marked with an asterisk (*) are required.

If this is an urgent matter involving immediate danger to safety or health, please contact your supervisor or appropriate emergency services right away.

Check Previous Incident

Date observed or first noticed

Type

Where did the incident happen?

Who or what was affected?

Description of event(s) or concerns

Are you willing to discuss this issue with us further? Yes (Compliance or HR Team May Contact Me)No (Remain Anonymous - Do Not Contact Me)

Do you want to save a copy of this report to your device? YesNo

Thank you for taking the time to report this concern. Your report will be reviewed promptly and, if appropriate, an investigation will be initiated. If you provided your contact information, you may be contacted for additional details or updates. All reports are handled with the utmost confidentiality, consistent with applicable policies and laws.