Compliments and Complaints Form

Please note we do not normally manage complaints longer than a year after the event.

Section 1a: Your details

First we need some general information about you:

 

If you are the Patient/Client go to Section 1b

If you are completing the form on behalf of the Patient / Client go to Section 2


Section 1b: Your details continued

The information in this section will help us manage your compliment or complaint more effectively

  

Section 2: Details of the patient or client affected

If you are leaving a compliment or complaint on behalf of someone else, please give us their details:

 

Your compliment or complaint

You may not be able to complete all these fields, but the more information you can give us will help us direct your comments to the right area or department.

 

Patient Consent

Anyone who uses any of our services can leave a compliment or complaint. You can also leave a compliment or complaint on someone else’s behalf, although you will generally need their written consent for complaints.

Please note, that to enable us to investigate your complaint, your personal information (eg. relevant health or social care records) may need to be available to the person/s investigating your complaint.

If you have any concerns about this, please contact our Complaints Department staff.

Please see the privacy statement for more information about how we use your information