Healthwatch North East Lincolnshire would like to hear about your recent experiences of using local health and care services. You can use this form to tell us when things have gone well and when you have been less than satisfied with your care.

Sharing your experiences only takes a few minutes, but the impact could last a lifetime. 
Your Privacy

Your views will be treated confidentially and anonymously.

We don't normally respond individually to what you tell us, but in some cases it may be useful to contact you to ask you more information. Please fill in your contact details below if you want us to get in touch with you to provide more information about an issue.

We will use the information you provide to help us look at the quality of local health and social care services. We will produce summary reports of all the views we receive, which we may sometimes share with other public bodies to assist them in performing their own duty to improve local services. We will not share your personal information without your permission.

All information will be handled and shared in accordance with the General Data Protection Regulation (GDPR) 2018. We will take all necessary steps to ensure that your information is treated securely.

Full details of our privacy policy are available on our website at: www.healthwatchnortheastlincolnshire.co.uk

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* 1. Please enter today's Date

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* 2. Which service would you like to tell us about?

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* 3. Tell us which ward/ department / name of service.

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* 4. Tell us about your care...What was good, what could have been better? Please provide us with as much detail as possible. 

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* 5. When did this happen? If you are telling us about a range of of issues on different dates, please specify below

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* 6. Would you like us to contact you to discuss your experience further?

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* 7. If yes to question 5 - please provide your contact details

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* 8. How would you prefer us to contact you?

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