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Submit a Complaint

Submit a Complaint

Please make sure you provide an email address and phone number (or both) as we are unable to reply directly to these form submissions. We will acknowledge receipt of your complaint within two working days and provide more information about the complaint process. If you are having any issues completing this form, please contact the Service User Feedback team on 028 9040 0999 (Mon-Fri 9am to 5pm) or via email at complaints@nias.hscni.net.

(If you do not know the date, please add a date you think is close)
DD slash MM slash YYYY
Your Name(Required)
Email(Required)
Are you completing this form on the behalf of the patient/does your feedback relate to another individual?
Patient's Name
(if different)
(please fill in this if your feedback relates to patient care)
MM slash DD slash YYYY
Address/Location of the Incident
How would you like us to contact you to thank you for your feedback and advise you of the next steps?
Is the patient aware that you're providing this feedback on their behalf?
Information about the way we use this data can be found in our privacy notice
This field is for validation purposes and should be left unchanged.