Please note, once you click the Submit button below you will send the form to our Care Direct Team who will review the information.
You will not be sent a confirmation email, instead, after you click 'submit' button you will see a page with a confirmation message.
Care Direct will look at the information’ you have sent to us and will take any action needed.
If, for any reason, you need to contact Care Direct, you can do so on 0117 9222700.
If your concern is urgent and outside working hours (Monday to Friday 8.30am - 5pm) phone the emergency duty team on 01454 615165.