In order to receive an acknowledgment and to ensure that we can contact you swiftly to clarify any elements of your request, please provide an email address. You do not need to give your postal address if you have provided your email address.
Please enter a brief title and the details of your enquiry below. Please do not use this form to request your medical records. If you would like to request a copy of your medical record, please complete our access to health records form and send to Medical Records Department, Mary Seacole Building, Trust Headquarters, Willerby Hill, Hull, HU10 6ED.