Send Thanks For Care

Please complete the form below, which will be emailed to Quinte Health's Patient Experience Specialist.

First Name*

Last Name*

Date of Visit

Which hospital are you referring to?

Belleville General Hospital

Trenton Memorial Hospital

Prince Edward County Memorial Hospital

North Hastings Hospital

General

Staff name if applicable

Comment*

How would you like to be contacted?

Phone

Email

I prefer not to be contacted

Can we share your positive experience with our staff?

Yes

Yes but please do not use my name

No

Can we share your positive experience publicly on our website and on social media (Facebook, Instagram, Twitter)?

Yes

Yes but please do not use my name

No

Email Address