Marie Curie Hospice West Midlands Healthwatch Solihull

Leave your Feedback

How do you rate your overall experience of this service?*

Summary of your experience* (max 45 characters)

Tell us more about your experience*

Where do you live? (town/city)

In relation to your comments are you:

What gender do you identify yourself as?

What is your sexual orientation?

Which age group are you in?

Do you consider yourself to have a disability?

Do you have a long term condition?

What is your religion?

What is your marital status?

What is your ethnicity?

Do you want to know more about how to make an official complaint?*

No Yes