Complaints form

Please use this form to complain about any aspect of your care and treatment, or that of a relative, that has failed to match your expectations.

Please note, fields marked with an asterisk (*) must be completed otherwise your complaint cannot not be sent.

To help us deal with your complaint promptly, please provide the following information where possible:

Complaint details:
(required)

(This will help us to identify the patient in our records.)
(required)
(required)
(Please enter date problem / incident first occurred)
(required)
Contact details:
(Please enter your name if you are NOT the patient)
(required)
(Please supply a number we can reach you on)

(Optional - to allow us to contact you if we miss you on the telephone / email.)
Our response:

Your feedback will be passed to a member of the customer care team who will contact you within three working days.


(Optional)

Please indicate how you would prefer to receive a response (if any):

No response required - providing feedback/comment/suggestion
A telephone call from relevant staff
A email from relevant staff
A letter from relevant staff
No preference

We assure you that your care and service provision will not be negatively affected by the fact that you have made a complaint.

 


Alternatively you can:

Write to:

Chief Executive,
Trust Headquarters,
Lincoln County Hospital,
Greetwell Road,
Lincoln
LN2 4AX

Or make a complaint to:

Customer Care Manager,
Lincoln County Hospital,
Greetwell Road,
Lincoln
LN2 5QY

Telephone: Customer Care Team on (01522) 573969

Email: customercare@ulh.nhs.uk