Clinical Negligence Enquiry Form

03332005926

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Clinical Negligence Enquiry

Please note this form should only be used for making a clinical negligence enquiry.

If you have a Personal Injury enquiry please complete this form.

About your clinical negligence enquiry:

Have you made a complaint to the NHS about your treatment?:

Yes No

If you have the complaint letter in electronic format you can upload it here (doc, docx, pdf):

Please note that before we can proceed with your clinical negligence case you must have made an official complaint to the NHS. If you have not already done so please go to NHS inform website where you will find details on how to raise a complaint in your area.

Is this enquiry about you?:

Yes No

Please give details of medical/dental treatment and your complaint:

The field must be filled in order to submit a form*

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