Continuity of Care

CoC - Contact Form

Please note that this form is not for urgent medical requests or same-day appointments. Please complete the form below if you would like Valentina, your CoC Care Coordinator, to contact you and arrange a review.

Name  Required
Date of Birth  Required

Please confirm your group and RAG rating

Care Group  Required
Patient Priority Category  Required

Please provide details of your request

Please provide a brief summary of why you would like the CoC care coordinator to contact you
Preferred Contact Method  Required
Consent  Required

Additional Information

Carers

Chaperoning

GDPR, Data Processing and Subject Access Request (SAR)

Infection Control

Long Term Conditions

Summary Care Records

Zero Tolerance Policy

Non-NHS Services

Patient Participation Group

Responsibilities

Talking Saves Lives

Winter Health

Community and Locality Services

Complaints Policy