• Complainant's details

  • Patients details (if different from above)

  • Details of complaint

  • Where the complainant is not the patient

  • hereby authorise the above complaint to be made and I agree that members of The Kings College Hospital Medical Centre staff may disclose (in so far as it is necessary to do so to answer the complaint) confidential information about me which I provided to them.
  • This field is for validation purposes and should be left unchanged.

You can view our Complaint Handling Policy here.