Home Forms Complaints Form Complaints Form Complaints Form Please read our Complaints Procedure before completing this form First Name * Last Name * Email * Date of Birth * Phone Number * Your named GP Details of your Complaint * Your confirmation *I understand the practice complaints procedure and timelines to be followed. Privacy Policy This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data. Your consent *I consent to the Practice collecting and storing my data from this form.