1. Choose the area of care you would like to tell us about?
Please select the options that you'd like to talk to us about. You can pick more than one.
3. Who does your feedback mainly relate to?

Tell us a bit about you

It would really help to know a little more about you so that we can better understand how people's experiences may differ. These questions are completely voluntary.

5. Please tell us your gender
7. How would you describe your sexual orientation?
8. How would you describe your marital status?
9. Please describe your ethnicity
10. How would you describe your religious beliefs?
13. Do you identify with any of the following? Select as many as you need to.
13. Are any of the following relevant to you?
11. Do you consider yourself to have a disability?
12. If you consider yourself to have a disability, how would you describe it?
13. Do you consider yourself to have a long term condition?
14. If you consider yourself to have a long term condition, how would you describe it?
16. Where did you hear about us?
17. Do you currently receive our monthly newsletter?
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How we use this information

The information you share with us helps us spot trends to identify areas for improvement. We may use quotes in our reports, but we will not use any information that will identify you.

As well as your feedback, we also ask you to volunteer some personal information. This helps us to help us understand how different groups experience health and social care services in Milton Keynes, and supports our focus on improving equality, diversity and inclusion. 

If you are sharing information on behalf of another person, make sure that you have their permission to do so, or the information you do share should be anonymous.

Find out more about how we handle your information in our privacy statement

In sharing your feedback with us, you are consenting to Healthwatch Milton Keynes (HWMK) using the information you have provided in the following ways:


·         At a local/national level to identify themes in issues across health services nationally and locally.
·         For statistical analysis on the impact of personal characteristics on people’s experiences of health and social care,
·         Anonymously in marketing content on our website, social media and other communications materials.