Share your experiences

Your story can change local health and social care services

A short video about the importance of providing feedback

Use the form below to share your experiences, good or bad, about health or social care services in Surrey. The more detail you can give, the more this will help us to build up a picture of people’s experience of services in Surrey.

Your feedback may be shared with those responsible for health and social services in Surrey and may be used in Healthwatch reports and publications to help influence the way services are delivered in the future.

For information about how your personal data will be processed and stored please refer to our Privacy Statement.

If your message is about general feedback or you just want to get in touch, please Contact us.

You can also request a paper copy of this form to complete or contact our Helpdesk by:

Phone: 0303 303 0023

SMS (text only): 07952 787533

Email: enquiries@healthwatchsurrey.co.uk.

Please list the services used. For example, the name of the GP Surgery, hospital, care home and so on.*

Summary of your experience* (max 45 characters)

Tell your story here. What was good? What could have been better? How did you feel about your care?

How did you hear about Healthwatch Surrey?

Is this experience about you?

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About you

Name

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Email(Your email will be kept private and you will not be sent any marketing material)

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I consent to being contacted regarding my feedback by Healthwatch*

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I confirm I am over the age of 16*

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I have parental consent*

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Thank you for sharing your experience with us. This will now be reviewed by Healthwatch Surrey.

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Your story can change local health and social care services

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