Complaints form

We understand that sometimes you’d like to raise your concerns in writing, especially if you feel you were unable to talk about your experience face-to-face.

Things to remember

  • Please tell us as soon as something happens, or as soon as you’re aware that something has happened – a complaint should be made within 12 months of that date.
  • Give as much information as possible, including your name, address and hospital number.
  • To help us understand what happened, you can use headings, numbered lists or bullet points. Ordering the events as they happened will also help us in our investigation.

The complaints process can’t look into:

  • disciplinary issues (for example, termination of contracts, striking off health professionals or suspension of registration).
  • private healthcare providers, unless it was funded by the NHS.

Complaints form

Your complaint

Note: Questions marked by * are mandatory