Feedback

If you have any comments or suggestions you would like to make about our service please fill in the form below and click Send at the bottom to email it to us. The form is anonymous so you do not have to send us your name and address or any other personal information. The data will be sent over the internet so please do not include any personal information. If you would like a reply, please enter some contact details in the Additional Comments field at the end of the form.

All the fields are optional so you can leave any of them blank if you feel they do not apply to you.

When did you contact the service?  
Your Telephone Call
Was the speed of answering
Operator attititude
Operator efficiency
Comments
Telephone Triage
Who did you speak to?
Speed of callback
Attitude
Knowledge about your problem
Professionalism
Ability to reassure you
Advice or Treament effective
Comments
Primary Care Centre
Professional Seen
Duration of your wait to be seen
Attitude of professional you saw
Knowledge about your problem
Professionalism
Ability to reassure you
Advice or Treament effective
Comments
Home Visit
Type of professional seen
Wait
Attitude of professional
Knowledge about your problem
Professionalism
Ability to reassure you
Advice or Treament effective
Comments
Additional Comments
Is the patient male or female?
How old is the patient?
Enter the first 3 digits of your postcode
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Tel: 0121 6934100        Fax: 0121 6934111