Report a Concern

Need to report a concern, complaint or a violation?

AMS is committed to the highest standards of business and clinical practices including: integrity, honesty, ethics, professional conduct, and safe practices. As a part of our compliance program, AMS strives for continuous improvement in all aspects of our operations. We encourage you to communicate any concerns you have in regards to our staff or our operations. To report a concern, please complete the form provided below and include a written description of the concern. Your submission will be sent confidentially to an AMS officer.

You may also send your concern, complaint or violation in writing to:

American Medical Staffing
2020 Lindbergh St.
Tyler, TX. 75703
Attn: Compliance Dept.

Download Complaint/Occurrence form here.

Please tell us about your concern:

What is the nature of your Concern?: *

If other, please explain:

Name of person involved?:

Where (or what unit) did the violation/occurrence occur?:

Date of the violation/occurrence? :

Time of the violation/occurrence? :

Name of any witnesses to the violation/occurrence:

Did this occurrence result in a bad outcome for a patient? :

Yes

If an injury / exposure involved our staff, were they seen by a physician?:

Yes

Was an incident accident report completed?:

Yes

(If yes, please report this to us immediately (24 hrs/day), and fax incident report immediately to our office at 903-597-1779 or Toll fax 888-NURS-FAX or 888-687-7329)

Please provide a detailed description of the incident, violation, injury or occurrence or any concerns.:

First Name of person completing this report:

Last Name of person completing this report:

Title of Person completing this report :

Your organization/Facility Name :

Your Email address:

Your Work Phone number:

Cell Number (if applicable) :

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Report a Concern

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