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Your Details

I am
     
Title*
Forename*
Surname*
Date Of Birth*
Email:
What pronoun do you use?
Address*
Postcode*
Home Phone:
Mobile Phone:

Have you complained in writing to the practice? Please send a copy of your complaint and any response from the practice to: enquiries@opticalcomplaints.co.uk quoting your name

Describe your complaint
(please state clearly what
happened and when,
details of your discussions
with the practice and
what in particular you are
unhappy with)
How would you like your
complaint resolved?:
Have you complained in
writing to the practice?
If yes, please send us copies
of all correspondance.
Where did you hear
about the OCCS

Practice Details

Practice Name*
Address
Postcode
Phone:
Website:
Email:
If your complaint relates to a particular practitioner, please provide the name:
Practitioner Title
Practitioner Forename
Practitioner Surname

Equality & Diversity

Age
Which of the following most accurately describes you
Disability
Ethnicity
Sexual Orientation
Marital Status
Religion
Region
Country

Contact

The OCCS will review the information provided and will contact you within the next 5 working days. How would you like us to contact you?
Contact

Declaration

Please read the terms below and click I agree. We will not be able to assist you if you do not agree to all of the statements.

  • To the best of my knowledge everything I have reported to you is correct
  • OCCS has my permission to contact the optical practitioner or practice involved
  • I understand that OCCS will share in strict confidence information provided by me with others who are directly involved in the investigation of my complaint, including the General Optical Council
  • I will treat any information provided to me by OCCS as confidential and will not pass this on to anyone else
  • I will cooperate fully with OCCS during their involvement with my complaint
I Agree*