Create a complaint letter

If you need to raise a complaint with your dental practice but are not sure how to do this, telephone them. Explain your concerns and let them know that you would like them to deal with your complaint. You can also ask for a copy of their complaints procedure.

Alternatively, just fill in the form below to create a letter of complaint which you can send to your dental practice.

Your Details

Dental Professional Name

Dental Professional Address -Insert Dental Professional Address-

Your Name

Your Address -Your Address-

Complaint Details

Date which caused the complaint

I previously contacted the following

Treatment or Service supplied
(Ctrl click for multiple)

Main cause of complaint -Cause of Complaint-

Select how you want this complaint
resolved (Ctrl click for multiple)

Other Details -Other Details-

Please Select
Advice
Bridge
Check up
Cosmetic dental work
Crown
Dentures
Extraction of tooth
Filling
Gum disease
Veneers
Other service or treatment

Please Select
Explanation
Apology
Mistake putting right
Relief of pain
Refund of fees
To stop this happening to someone else