Compliments, Complaints and Suggestions Form

Please complete the details below, noting:

1. All identifying information is optional. Name can be left blank. You can use anonymous@beechworthsurgery.com.au if you do not wish to insert your own email into that field.

2. Let us know if you wish to be contacted, and supply your email or phone number if so.

3. Provide as much information as possible in the message section below about the issue you wish to bring to our attention.