Complaints Form

Title
First Name
Surname
Email
Telephone
Your address
Building name/number
Address Line 1
Address Line 2
Town/City
Postcode
County
 
AIHHP Member Details

AIHHP Practice/Member

Postcode of AIHHP Member
 
Please describe the issues you have below, including dates (where possible) or occurrence.

Please describe what response you have had so far from the AIHHP Member.

Please describe how you envisage the issues being resolved.

If you have taken any other action in regards to the complaint, please specify below.

Declaration

I verify that I have contacted the AIHHP Member with my complaint in writing.

I verify that the above information is true to the best of my knowledge.

I understand that it will be necessary for AIHHP to contact me and the AIHHP member I am bringing a complaint against in order to investigate this matter further.