How to fill in the form


Information about you and your group

When you send us information we need to ask for your contact details, and some information about you. This is in case we need to get back to you about what you have told us. We will not share this information.

We will also ask you for information about where your views have come from. We would like to know:

  • how many local people share an experience of care;
  • how your organisation or committee reached its conclusions.

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Information for you and your group

We publish quarterly bulletins throughout the year that ask for your views and experiences of health and social care services. 

Read the bulletins that we have published so far:

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Sharing the information you send us

Your information will be analysed and used to determine risk and quality in each service. You do not need to share the information you send us with any health and social care services. However, we hope that you will use it as part of your discussions with local services about making care better.

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Top tips for providing evidence

  • Tell us what matters most to your group and the people in your community. What are the most important points you want to get across?
  • Think about examples of good practice, as well as areas that should be improved.
  • Read about the new essential standards for quality and safety that we expect all health and social care services to meet.
  • We are interested in all recent experiences of care. It would help if you can give us information you have gathered since 1 April 2009.
  • Try to find facts and examples to back up your information. These may include notes from a meeting or visit to a service, the results of a local survey, or a set of personal stories form individuals with dates and supporting documents.
  • Please note that your information must not include any confidential or personal details, such as the names of individual patients or staff, or their contact details.
  • You can send us supporting information but you do not need to. We may ask you to show us this to help us use your information.
  • It will help us to know whether the views or experiences you tell us about are common among the people using a service or in a community.

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Fill in the form

We recommend you print off the feedback form below to decide which sections you want to fill in before you start the online version. It is not possible to save a draft of your online form.

Download the feedback form (DOC, 67KB, opens in new window)

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See also