My issue(s) is/are: Please provide full details such as who experienced the issue, where, when, who else was involved. *
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Tell us briefly what was good, what wasn’t so good about your experience and how it could be improved *
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My feedback can be shared with service providers as written/shared with Healthwatch Cornwall, with consent to provide my name/Personal Identifiable Information to the service provider, should they wish to investigate my experience further. *
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In relation to this experience, please tick the box that best describes you
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The first part of your postcode i.e TR15
Age
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Gender
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Is your gender identity the same as the sex your were assigned at birth?
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Ethnicity
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Sexual Orientation
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Are you a carer? For example, do you look after, or give help or support to family members, friends, neighbours or others because they have either long-term physical or mental ill-health / disability, or problems related to old age? (excluding care or support provided as part of paid employment)
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Disability
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If you have a disability or long-term condition(s), please tell us which ones:
Your contact details
Can we contact you if we need to check any of the details you have shared with us
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Phone number
Additional information
Your story could help to raise awareness and encourage others to speak out. Healthwatch Cornwall would like to use your story as a case study or in a relevant press release. Please indicate if you are happy for us to do this. If yes, we may need to call/email you for more information. Thank you.
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