- Feedback

Feedback

Dear patients and visitors!

You may share your experience, praises and complaints with us or make a suggestion by filling the feedback form.

When did the event take place (dd/mm/year):*

Location of the event (clinic, service, department, office):*

Description of the event (pleace specify what happened and who were the persons involved):*

Your name and surname:*

Would you like to receive response to your appeal?:*

Yes No

Your e-mail address:*

Phone:

Control question

answer to 1 plus 3 is:(enter the correct answer in numbers)

Thank you!

	Yes, regurarly
	I had no idea that there were any