Submit A Complaint – NHIMA

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SUBMIT A COMPLAINT

To complete the form successfully, please make sure to fill in all the fields marked with an *. These fields are required to proceed.

Not happy about services provided?
Submit a complaint below

Facility Name

Facility Location

Nature of Complaint

Date

Is this the first time you are experincing this ?

Yes No

First Name

Surname

ID Number

Primary Mobile Number

Alt Mobile Number

Email

Physical Adress

Complainant Type

NHIS Principal NHIS Beneficiary Both

Has anything been done to resolve the complaint

Yes No

Upload a file here

1. How long did it you take to receive treatment at the facility?

Less than 1 hour Between 1-2 hours More than 2 hours

2. Have you been given a prescription to get medication at a private pharmacy?

Yes No

3. Have you been given a lab request form referring you to be tested at a private lab?

Yes No

4. Does the facility close access to NHIMA services at night and during holidays?

Yes No

5. Is the environment clean, are toilets functional with running water, does the waiting area have sufficient furniture?

Yes No

6. Is the attitude of attending staff towards you cordial and pleasing? ?

Yes No

7.How would you rate overall service you received?

Satisfied Partially satisfied Not Satisfied

Date of Complaint

I certify that the information I have provided in this complaint form is true, complete, and accurate to the best of my knowledge. I understand that submitting false or misleading information may result in legal action and the potential invalidation of my complaint.

Head office, Stand No. 27396, Public Service Pension Fund Building, Alick Nkhata road, Longacres Mall, Lusaka Zambia

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