Complaint Form/ Feedback form

Please do not use this form to submit a general enquiry if you are expecting to get a reply to. You can call us directly or email us with your query. Please see a copy of our complaints procedure from this website.

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Complaint

Your Complaint/ Feedback *

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. *

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Page last reviewed: 19 December 2024
Page created: 20 November 2023

Complaint Form/ Feedback form

Complaint Form/ Feedback form

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