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Counties Manukau District Health Board (CMDHB)

Online Feedback Form

Counties Manukau District Health Board welcomes any complaints or suggestions for improvement about our staff and services that you may have. Any feedback will help us to improve on the services we provide to our patients.

Please complete the form below and click on the "Submit" button once finished:

We will acknowledge receipt of your complaint within five working days.
We will endeavour to investigate your complaint within 20 working days from the date of acknowledgement. You will be informed if this will take longer and the reasons why it might be necessary.

Details of Person giving feedback: (fields marked with * indicate info required)
First Name & Surname: *
Street Address & Suburb: *
Suburb & City: *
Email Address: *
Phone No. (home):	(incl. area code)
Phone No. (work):	(incl. area code)
Best time of day to contact you:

Details of the Feedback:
Name of person affected: *
Are you are giving feedback on behalf of another person?	Yes, I am giving feedback on behalf of another person
If you are giving feedback on behalf of another person, what is the relationship between you and the affected person? e.g. "My mother"
Nature of feedback: *
Which service and/or person at CMDHB are you giving feedback about?
When did the event occur?:
If exact date is unknown, indicate approximate time frame:
Would you like to be contacted about this so that the matter can be further addressed?	Yes, I would like to be contacted to discuss further.

Published: 23-Aug-2007 | Website enquiries: Web Content Manager