Online Request

    Did you know that you can also contact us by using a secure and confidential online form on this website.

     Select the relevant issue you want,  answer the questions and follow the online instructions.

    We will send you an automated message by text or email to confirm that we have received your            online form.

    If you find it difficult to complete the form or you do not want to use it, you can call us on 0121 389 1100  or visit us.

The submitted forms will only be read during our office hours.

    Benefits of using an online form

     An online form is a quick and easy way of letting us know what is wrong or raising a query or concern. This can help you get the right care when you need it.