Comments and Suggestions Form


This is for patient use only - Please only use this form for comments about the practice and suggestions as to how we can improve our service to you.

Medical matters will not be dealt with via this form. If you have a query regarding a medical matter please telephone reception to make an appointment to see the appropriate person.

Surgery Complaints will not be answered via the website, all surgery complaints must be in writing and addressed to the practice manager at the surgery address.

We will not reply to third parties requesting advertisement.
What kind of comment would you like to send? Remember this form is not for medical matters.
Your comment is:
Please choose an option      
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.