Healthwatch Solihull Service Satisfaction Feedback Form

Thank you for your previous contact with Healthwatch Solihull and for completing this satisfaction feedback form about your contact with us.

Telephone

Face to face

I left feedback about health and social care on the Healthwatch Solihull website

I completed an online questionnaire

Other (please specify)

A patient/ service user?

A relative or friend of a patient/ service user?

A professional working with Healthwatch Solihull?

A volunteer?

Other (please specify)

Leave feedback about health and social care

Obtain information

Both of the above

Other (please specify)

Date / Time

Date

Very satisfied

Satisfied

Neither satisfied nor dissatisfied

Dissatisfied

Very dissatisfied