Complaints | KT Healthcare

Patient experience

Complaint Form

If you need any help completing this form, please contact the team on 0333 004 7700 or email patientexperience@kirsoptaylorhealthcare.com. You can also post your complaint to Kirsop-Taylor Healthcare Ltd, Office 43, Chichester Enterprise Centre, Terminus Rd, Chichester, PO19 8FY.

Your details

Name of complainant*

ICB name (if known)

Your address*

Patient details (if you are not the patient)

If you are making a complaint on behalf of someone else, we will need their permission to correspond with you. This is to meet our legal obligation to protect patient confidentiality. If the patient does not have capacity, we will need consent from their next of kin, as listed on their records.

Name of patient

Patient reference number (if known)

Patient date of birth

Patient address

How would you prefer us to contact you?*

By telephoneBy email

Telephone number(s)

Email address

About your complaint

Date(s) of the incident(s) or event(s)*

Where did the incident(s) or event(s) take place?*

Please give an account of what happened. Include names of staff, places where things happened, etc.*

What questions or concerns would you like us to answer or investigate?*

What outcome are you looking for as a result of making this complaint?*

I consent to having KT Healthcare collect my name and email so that they can contact me about my enquiry. For more info check our Privacy Policy where you’ll get more info on where, how and why we store your data.

I agree

Thank you!

We've received your complaint. A member of our patient experience team will be in touch.

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