Dorridge Surgery - Your suggestions

Your suggestions

PATIENT'S SUGGESTIONS

PLEASE NOTE: THIS FORM IS FOR SUGGESTIONS ONLY AND SHOULD NOT INCLUDE ANY PERSONAL MEDICAL DETAILS. PLEASE CONTACT THE SURGERY IN PERSON OR BY PHONE IF YOUR ENQUIRY IS OF A PERSONAL NATURE.

We welcome suggestions from Patients to improve the service that we provide from the Surgery.

Please give your comments below together with your contact details, this will enable us to clarify the comments you make and also keep you posted of the outcome.

Your suggestions

SUGGESTION

NAME

POST CODE

TELEPHONE NUMBER

EMAIL ADDRESS

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key known only to the GP practice and is accessed over a secure connection by nominated Practice staff. Our practice has a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to
Dorridge Surgery • 3 Avenue Road, Dorridge, Solihull, B93 8LH.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

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