Complaint form

You can speak to any member of staff initially with your complaint. This gives you the opportunity to resolve any concern you may have without it going through a formal process. Most complaints are best resolved within the practice and these should be made via the Practice Manager.

If you wish to initiate our formal complaints procedure, please complete the form below.

Make a Complaint

First Name *

Last Name *

Email *

Date of birth *

Please use format day/month/year e.g. 12/05/1979

Phone Number *

Summary of Feedback/Complaint *

0 of 250 max characters

Have you experienced this issue before?

Yes

This may include at this surgery or at previous healthcare provider.

Please provide details of previous experience and how/if it was resolved *

0 of 250 max characters

Please describe how this issue may have occurred *

0 of 250 max characters

Please describe any specific outcomes from this feedback *

0 of 250 max characters

I confirm that my enquiry is not urgent, and understand it may take up to 5 working days or more before I receive a reply.

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.

I consent to the Practice collecting and storing my data from this form.

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