Complaint Form -Hermitage Medical Practice, EDINBURGH

This is a complaints form for Hermitage Medical Practice, 5 Hermitage Terrace, Edinburgh. Please do not use this form unless you want to complain about the Practice directly. Thank You

Your Details

Name *

Date of Birth *

Phone Number

Email Address *

Complaint

Your Complaint *

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. *

I consent to the practice collecting and storing my data from this form.

This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Page last reviewed: 10 November 2023
Page created: 03 February 2023

Cookies on the Hermitage Medical Practice website

Complaint Form -Hermitage Medical Practice, EDINBURGH

Complaint Form -Hermitage Medical Practice, EDINBURGH

Further Information