Complaints and compliments

If you wish to make a comment, complaint or compliment about our services or the care you receive, please use the form below.

Do you wish to make a: * required
Please select below




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If you are making a complaint on behalf of one of our service users, we will require signed consent from them, to take this forward on their behalf. If this is the case, when we have received this form, we will send you an acknowledgement letter and send a consent form to be signed by the patient/service user.



If you would like a reply, how do you wish us to contact you?


Have you contacted us previously about this issue?


If you are making a complaint please tell us who you are







   


   

Do you consider yourself to have a disability?



Does the service user/patient consider themselves to have a disability?



If yes do you have:










(If known)

Equality Information
We gather this information to make sure we are meeting the needs of all our service users, their relatives and carers. Please select the box that describes your ethnic origin


















(please state)



What is your gender?



What is the service user/patient's gender



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Your reference number for this form is: HPFT-C 58005