ࡱ> GIH  bjbj:U:U *X?gX?g ,,8 z$:::::#######$j& )$^^^$::4$^:::#^#V"@u#:K͊4" #J$0z$"x))u#)u#pvTD#;$$`z$^^^^),X : Your address XXXX XXXX XXXX Telephone Number: XXXX Date The Chief Executive 㴫ý Trust Offices Salisbury District Hospital Salisbury SP2 8BJ Dear Ms Hunter, Re: Please add name of patient, patient number, address, date of birth and gender (if you are writing about yourself or on behalf of someone else) State the event facts, including department/ward, dates of appointments/ inpatient stay, names etc. Make a list of the points you want answers to, for example: Why was my appointment cancelled? Why didnt I receive notification that it had been cancelled? State your suggested solution, for example: I want an apology; I want to know what actions are being taken to prevent this from happening to someone else; I would like a meeting with staff to discuss this further; I would like a second opinion or another appointment. Yours sincerely Name If you are writing the complaint on behalf of someone else, we will need their consent that they wish you to act on their behalf. Please add a statement at the bottom of the letter, for example: I authorise complainants name to make a complaint on my behalf). Signed: . Date: ....... (Patient) Print name: .      45:;On|  # 5 I N P Q Z `  R S  h45CJOJQJ^JaJhST5CJOJQJ^JaJh+( 5CJOJQJ^JaJh(::5CJOJQJ^JaJ#hCh45CJOJQJ^JaJhhiCJOJQJ^JaJhO CJOJQJ^JaJ hCh4CJOJQJ^JaJ4 45:;On|P Q  R S  & Fgd4gd4$a$gd4S  ) _ ` p q r s x y < =   & Fgd4 & Fgd4gd4 ) _ ` p q r s x y < = I V [ { | }  }yy}yy}yy}yyyhK.jhK.Uh4hdh4OJQJ^JhdhdOJQJ^Jh4CJOJQJ^JaJh46CJOJQJ^JaJhdCJOJQJ^JaJ#hCh46CJOJQJ^JaJhd6CJOJQJ^JaJ hCh4CJOJQJ^JaJ+ (. 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