Share your experience of mental health wards in Hackney

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1. What is the name of the ward you want to share feedback about?

Gardner Ward
Conolly Ward
Mother and Baby Unit
Bevan Ward
Brett Ward
Joshua Ward
Ruth Seifert Ward
I don't remember
Other (please specify):

2. Are you

The patient
Family member/ carer/ friend of someone who stayed at the ward

3. Did your experience occur in the last 12 months?

4. Please tell us about your experience

5. If you would like to talk to us further, please leave your contact details and we will get back to you within 3 working days.

6. What is your gender?

7. How old are you?

8. What is your ethnicity?

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