Our purpose is to listen to your views, share them with local health and social care providers - and encourage them to take action. 

NHS and social care staff are doing everything they can to keep us well during these challenging times, but there might be things that can be improved for you and your loved ones. Please take five minutes to share your story with us. Your views could make a big difference to services across South Gloucestershire.

You can review as many services as you like, and you can leave feedback every time you visit. This form is also available in Easy Read.

Indicates required field

Complete the survey

Choose the area of care that you would like to tell us about. Please tick all that apply.
Please select the options that you'd like to talk to us about. You can pick more than one.
If you were an NHS patient in a private hospital or other private service, please let us know in your comments below.
Please provide details of your experience/feedback e.g. What went well? What could have been better? How easy was it to access the help and support you needed? What impact has this had on your life?
Please let us know if you remember the day, month or year that this happened.

Tell us about yourself

We ask for some additional information so that we can make sure we're hearing from a wide range of people. Click here to find out why we ask about your gender, sexual orientation, and other demographic information.

Please tell us about you, even if you're completing the form on behalf someone else.

Your personal details will not be passed on to local services.

Please note we cannot accept feedback from anyone aged under 13 years. We can accept feedback about someone under 13, e.g. a parent providing feedback about their child's experience.
Please tell us your pregnancy or maternity status. You can select more than one option.
Do you have a disability/are you disabled, or do you have a long-term condition?
E.g. 'I have diabetes and arthritis', 'I have depression', 'I have a physical disability', 'I have a mental health condition'.
Do you consider yourself to be a carer? Do you provide unpaid care to someone?
Do any of the below apply to you? You can select more than one option.
Where did you hear about Healthwatch South Gloucestershire?
Consent
Using your story for media
To promote our campaigns we use people's stories to show what needs to change. The media (newspapers, radio or TV) ask if we have people who can their story when we publish a press release about our research. Would you be happy for us to contact you about your experience for media purposes or to use your story as a case study in our material? We won’t pass on your name and contact details to the media without speaking to you first about what it involves.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.