Sharing your experiences will help to improve health and social care services for you and everyone in Birmingham. We are independent of the NHS and Birmingham City Council, and have the power to ensure those organisations listen to and act upon people's views.
By completing this form you are agreeing for Healthwatch Birmingham to place your feedback on our website www.healthwatchbirmingham.co.uk For full terms and conditions please visit the website, email info@healthwatchbirmingham.co.uk or call 0800 652 5278

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* 1. Name of the service you are telling us about e.g Hill Medical Practice

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* 2. Tell us about your experience of this service

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* 3. How would you rate this service?

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* 4. Name (Leave blank if you would prefer to remain anonymous)

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* 5. Email address (We will not share your email address with anyone else. Providing it will enable us to keep you updated if the service respond to your views)

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* 6. Postcode (This is to ensure you are a Birmingham resident)

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