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Republic of Cyprus
Communication with the Ministry of Health (Suggestions/ Comments/ Complaints)
The fields marked with an * are mantadory.


APPLICANT INFORMATION
Name and Surname*:

Telephone Number*:

E-mail*:

APPLICANT INFORMATION

Name and Surname*:

ID Number*:

Telephone Number*:

E-mail*:

Relationship with the applicant*

SERVICE INVOLVED (Hospital/ Clinic or Department)*:

DESCRIPTION* (Please provide a brief description of the incident)


*
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I confirm that with the submission of this electronic form, I accept that personal and any other information included, will be forwarded to the authorized officer for assessment and then to the respective departments for further evaluation and action.




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© 2011 - 2019 Republic of Cyprus,
Ministry of Health

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© 2011 - 2019 Κυπριακή Δημοκρατία,
Υπουργείο Υγείας