Keeping Families Connected

With visiting restricted across the whole of Northern Health, there has been an increase in feedback from family members to the Patient Experience Team. This form allows you to send messages to your relative by using our online form/email .
  • Please enter patient's full name here.
  • Please enter patient's address here.
  • If you are aware of the patient's date of birth, please enter here.
  • Please let us know which ward the patient is in

  • Your details

    Please enter your details below.
  • Please enter your name here.
  • Please indicate your relationship to the patient.
  • Please enter your email address .
  • Please enter your phone number.
  • Please enter your message here (max 1000 characters)
  • Max. file size: 64 MB.
    You are welcome to include a photograph.
  • Max. file size: 64 MB.
    You are welcome to include a second photograph.
  • Please confirm you are happy to have your message to be read out to your loved one and agree with the Northern Health Privacy Policy.