Contact This form is for general enquiries. If you would like to share your experience of a local health or social care service, please click here. You can also call our Helpdesk on 0303 303 0023 (local rate) The Helpdesk is open 9am-5pm Monday - Thursday and 10am-4.30pm on Fridays. For media enquiries, please contact our Communications Officer, Lauren ter Kuile on 07545 433465. Thank you. Any details you share with us will be held in accordance with the Data Protection Act 1998 and will be treated anonymously. We will not share information that you personally without your permission. Name* Email* Contact NumberSubject*Please selectVolunteerEventsPartnershipsWeb enquiryRequest ContactMedia EnquiryOtherComment*Please tell us your genderPlease selectFemaleMaleTransgenderOtherPrefer not to sayPlease tell us your age rangePlease select0-1718-2425-4950-6465-7980-8990+What is your ethnic origin?Please selectArabAsian / Asian - BangladeshiAsian / Asian - IndianAsian / Asian - PakistaniAsian / Asian - NepaliAsian / Asian - any other asian backgroundAsian / Asian - not statedBlack - AfricanBlack - BritishBlack - CaribbeanBlack - any other backgroundBlack - not statedChinese or other ethnic background - ChineseChinese or other ethnic background - Other ethnic backgroundMixed background - White and AsianMixed background - White and Black CaribbeanMixed background - any other mixed backgroundMixed background - not statedWhite - BritishWhite - EuropeanWhite - Gypsy/TravellerWhite - any other white backgroundWhite - not statedNot statedPrefer not to sayDo you consider yourself to have a disability?YesNoPreferred method of contact Telephone Email Would you like to receive our monthly e-bulletin?*YesNoIf you would like to receive regular e-bulletins from Healthwatch Surrey, please choose "yes".How did you hear about Healthwatch Surrey?e.g. through a friend; a leaflet in my doctor's surgery, an article in the pressPhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.