Welcome to the LfE reporting form.

Forms will be forwarded to the supplied email address, and also to registered LfE champion(s) at the selected location.
It is your responsibility not to enter any patient identifying information.

About you
This would help us to contact you to discuss this report.
We would use this to copy you by email.

This will help us understand who reported this example.
Who achieved excellence?
This will help us to contact the practitioner.
This would help us contact the practitioner by email.
Start typing a location, then choose from the list.
About the excellence
Please do not include sensitive personal information.
Please explain what we can learn from this example.
About our use of your report
Thank you for submitting this excellence report. In order to comply with GDPR regulations we require your consent to store this information for the purpose of sharing the positive feedback with the individual and organisation you have cited. The information will be deleted from our servers at regular intervals. To give your consent, and to confirm that there are no patient identifiers in this form, please tick this box.