Comments and Suggestions Form


Please do not use this form to request repeat prescriptions or to make a complaint. Repeat prescriptions should be requested via Patient Access (see Online Services under Quick Links). Complaints should be in writing to the surgery address please.

This form should only be used for general comments about the practice and suggestions as to how we can improve our service to you.
What kind of comment would you like to send? Remember this form is not for medical matters.
     
What would you like to say?

Your contact details
Do you agree to be contacted regarding this matter?

About This Form

Note that by using this form, you will be sending information about yourself across the Internet. Whilst every effort is made to keep this information secure, you should be aware that we cannot offer any guarantees of absolute privacy. If this matter concerns you then you should use another method to notify us of your comment.

Your IP address () will be sent with your communication. In rare cases where abuse or criminal activity can be shown to have taken place this may be used by the authorities to trace you.