Complaints Submission Form

We value your feedback and are committed to addressing your concerns thoroughly. Please provide as much detail as possible to help us understand your experience and how we can resolve your concerns.

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Patient details. Please fill out the details of the patient below.

Note: Questions marked by * are mandatory

*This is a mandatory field. Title

*This is a mandatory field. Patient full name

Preferred name

*This is a mandatory field. Date of Birth

*This is a mandatory field. NHS number

Date of death (if applicable)

Email address

Phone number

Postal address

Adjustments required

Preferred contact methods

Phone
Letter
Email

Is the patient a member of the armed forces or veteran?

Yes
No

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Thank You

Thank you for taking the time to share your concerns with us. We are committed to resolving them in a compassionate, thorough, and timely manner. Once we receive your submission, we will acknowledge your complaint within three working days.

If you have any questions or need assistance completing this form, please contact our Complaints Team at

plh-tr.complaints@nhs.net

or call us on 01752 439884

You can also fill out our complaints form document and email it to the team Complaints form.docx [docx] 63KB