Comments and Suggestions Form

This form is for comments and suggestions only.

If you have a medical query telephone reception to arrange to see an appropriate healthcare professional.

If you have a complaint contact the reception team and they will direct you to the complaints lead in the practice.

Your comment/s or suggestion/s

Do you agree to be contacted about your comment or suggestion?If yes please provide your details in the questions below

First Name

Surname

Telephone Number

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 and is accessed over a secure connection by nominated staff. We have 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 Moorside Surgery • 370 Dudley Hill Road, Bradford , BD2 3AA.

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.