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Formerly Southport and Ormskirk Hospital NHS Trust

Patient Feedback Form

1 - How was the care you received?*:

2 - Which service did you attend on your latest visit?*:

3 - Did you receive any relevant information relating to your appointment in a timely manner?*:

4 - Do you wish to raise any concerns regarding your care?*:

5 - Are there any improvements you think we could make?:

6 - On a scale of 1 to 10, where 1=Poor and 10=Exceptional, how happy were you with the service we provided?*:

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Patient Advice and Liaison Service (PALS)

Our Patient Advice and Liaison Service (PALS) can help with questions and concerns you may have.

Very often issues can be resolved straight away, so please contact PALS as soon as possible. They can:

  • Direct queries to the relevant staff or departments
  • Provide information about NHS services
  • Listen to concerns and suggestions
  • Support raising a complaint
  • Help with a quick resolution to problems

Email PALS at or telephone 01704 704703. Office hours are 09.00am to 4.00pm, Monday to Friday. Please leave a message at other times and on public holidays.

Feedback Form