Express a Concern

Please complete the form below, which will be emailed to Quinte Health’s Patient Experience Specialist. Please note that this form is not monitored by medical professionals. If you require medical advice, please contact your primary healthcare provider, visit your nearest walk-in clinic or emergency department, or contact Health Connect Ontario.

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Name *

First

Last

Email *

Phone *

Date of Visit

Which hospital are you referring to?

• Belleville General Hospital
• Trenton Memorial Hospital
• Prince Edward County Memorial Hopsital
• North Hastings Hospital
• General

Staff Name (if applicable)

Comment *

How would you like to receive follow up?

• Phone Call
• Email
• Please do not contact me

Submit