General Practice SA Inc : Customer Feedback

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   Customer Feedback

   Please complete the form below and click Send to submit to GPSA.

   We appreciate your feedback and will work continuously to improve what we do.

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Is your feedback:	an improvement suggestion a complaint / negative feedback a compliment / positive feedback
Do you want your feedback to be confidential? (Choosing 'Yes' ensures your information is protected under our Privacy Policy and Procedures)	Yes No
Would you like a response to your feedback? (Our aim is to provide a response within seven working days of receipt of feedback)	Yes No
If yes, how would you like us to contact you? (Please provide a name and contact details)
Does your feedback fit any of the following categories?	Service provision Communications Relationships Responsiveness Accuracy or lack of Other (please specify)

Please provide details of your feedback