lf you have a question or concern, let our staff know. Your feedback is important to us. Please use the feedback form below. First Name Last Name Email Phone Mobile Preferred method of contact---Phone CallEmailEither Address 1 Address 2 City/Suburb State Postcode Does your feedback relate to a specific Hospital or clinic?NoMercy Hospital for WomenWerribee Mercy HospitalMercy Mental HealthMercy Health AlburyMercy Care Centre Young Ward/area/service you are commenting on Are you the patient or client?---YesNo Patient or client ID number (if known) Patient or client DOB What is the patient or clients name? Do you identify as Aboriginal or Torres Strait Islander?---AboriginalTorres Strait IslanderBoth Aboriginal and Torres Strait Islander Your comments* Do you require a reply to these comments?---NoYes Do you require an interpreter? (if yes what language)---NoYes What language do you require an interpreter for? What would you like to see happen as a result of your comments?---Access to serviceApologyBrought to attention of Department ManagerChange in procedure or policyExplanationNot sure, I am just registering my concernOther (please specify) Other * indicates a required field Send feedback Share this page Share it around Tweet about it Share this on LinkedIn Print this page Email this page
