Contact the Practice Manager

You can use this form to email queries or comments directly to the Practice Manager. Please do not use it to submit Clinical Information, or to request or book appointments.

Please select the practice location most relevant to this Online Form submission:

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Query:Please type your query or comment above.

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to Balsall Common Surgery • Balsall Common Health Centre, 1 Ashley Drive, Balsall Common, Coventry, West Midlands, CV7 7RW.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.