Express a Concern

Please complete the form below, which will be emailed to Quinte Health's Patient Experience Specialist. Please note that this form is not monitored by medical professionals. If you require medical advice, please contact your primary healthcare provider, visit your nearest walk-in clinic or emergency department, or contact Health Connect Ontario.

First Name*

Last Name*

Email Address*

Phone*

Date of Visit

Which hospital are you referring to?

Belleville General Hospital

Trenton Memorial Hospital

Prince Edward County Memorial Hopsital

North Hastings Hospital

General

Staff Name if applicable

Comment*

How would you like to receive follow up?

Phone Call

Email

Please do not contact me