Psychiatry-UK Complaint Form

Please Note:

After you submit this complaint form, we will contact you within 15 working days. If we cannot resolve your complaint within this timeframe, we will provide you with an update.

Once a full investigation is complete, you will receive a full response to your complaint as soon as possible.

Are you an existing patient?

Yes

No

Are you raising a complaint on behalf of a patient?

Yes

No

We keep to the strict rules of medical and personal confidentiality. If you wish to make a complaint and are not the patient involved, we will require the written consent of the patient to confirm that they are unhappy with their treatment and that we can liaise with third party about concerns raised. Please be aware that if you are not currently a patient we may not be able to take you through the complaints process. However, we will ensure that any issues raised are dealt with by the appropriate department and we appreciate any feedback that you bring to our attention.

If you are making a complaint on behalf of an existing patient, please state your relationship to them

Your full name

Patient's full name

Patient reference number (If known)

Your email address

Your contact telephone number

Patient's date of birth

Patient's full address including postcode

Town

County

Postcode

Country

Have you contacted us about this previously?

Yes

No

Dates and times when this was reported (if known)

Names of any individuals you may have dealt with (If known)

Is your complaint in relation to any of the following areas (select all that apply)

Details of your complaint

Please provide as much detail as possible in order for us to investigate your complaint. If applicable, please provide details of any department and/or staff involved.

Outcome

As a result of raising your concerns, what would you like to see happen? What do you consider to be a suitable outcome to resolve any concerns. Please note that we cannot guarantee this outcome, but we will make every effort to resolve the complaint to your satisfaction.

Is there anything else you would like us to know?