Fields marked (*) are mandatory. Before completing the form, read the conditions of use carefully


 

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Some other file extensions may not be accepted.

Use conditions of the AMS Ombudsman Office:

• Your complaint will be forwarded with disclosure of relevant data, including personal data, to the area of the company responsible for treatment.
• If you check 'Other', in the “Employment Relationship” field, the data requested in the form is yours. The full name and AMS’ registration of the beneficiary (holder or dependent) must necessarily appear in the 'Message' field. In the absence of the beneficiary's AMS registration, please inform us the Petrobras or Petros registration number or the beneficiary CPF.
• It may be necessary to contact you for clarification or information. In this case, the deadline to attend your demand (complaint, requests, suggestions or compliment) will count from your response to our request. Therefore, make sure that the informed contacts are correct.
• When your demand is related to a health service provider of the accredited network, make sure that the full name is included at the 'Message' field.
• When informing the existence of an AMS protocol number in the 'Message' field, please also inform any response received, so we can handle the demand from this point forward.

I accept the use conditions.*

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