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You should be aware that this web form is not a secure method of transferring information. We are not able to guarantee the security of personal or confidential information submitted on-line before we receive the information.

The information submitted using this form will be held and used in accordance with the Data Protection Act 1998. The Data Controller is South Staffordshire and Shropshire Healthcare NHS Foundation Trust. The Trust will not disclose such information to any unauthorised person or body but where appropriate will use such information in responding to your complaint. The Trust will store this data in an electronic format and may also use this data in connection with the prevention or detection of fraud or other crime.

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