Tell us about your own experiences of health or social care services
Any information you give us on this form will be used in accordance with data protection regulations. If you give us your name or other contact details, we will not disclose those to any third party without your express permission. We may use your experiences to highlight to decision makers in health and social care how services could be improved, but you would not be identifiable as an individual.
How we use this information
The information you share with us helps us spot trends to identify areas for improvement. We may use quotes in our reports, but we will not use any information that will identify you.
As well as your feedback, we also ask you to volunteer some personal information. This helps us to help us understand how different groups experience local health and social care services and supports our focus on improving equality, diversity and inclusion.
If you are sharing information on behalf of another person, make sure that you have their permission to do so, or the information you do share should be anonymous.
Find out more about how we handle your information in our privacy statement.
Take five minutes to share your experiences
NHS and social care staff are doing everything they can to keep us well during these challenging times, but there might be things that can be improved for you and your loved ones. Please take five minutes to share your story with us.
1. Choose the area of care you would like to tell us about: (Select all that apply)
2. Please provide the name of the service you are telling us about e.g. Lincoln County Hospital
3. Please tell us about your experience (e.g. what went well? What could have been better?)
4. Does your feedback apply to a specific service? If so, please tell us which one(s) e.g the GP surgery name or hospital department
5. Please leave your contact details below:
6. Where do you live?
7. What is your postcode? (This is for the purpose of mapping and monitoring inequalities only.)
8. How easy was it to access the help and support you needed?
9. How would you describe your experience of care?
10. In relation to this experience, please select what best describes you: