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Patient Care form

We continually strive to improve our care to patients; please help us by dropping your comments into our suggestion box. If you're not sure where this is, please ask a member of staff.

Please tick the phrase you most agree with:

Keeping your feedback confidential

This survey is confidential, however, please complete your contact details if you would like us to call to discuss your comments.

Feedback will be reviewed every six months, but your name will never be disclosed with the results. You can fill in all or parts of the following:

Appointment details

Contact details

Thank you for your time