Aftercare Support Contact Form

Simply fill in the form below to get in touch with our team.

Full name *

Email *

Contact number

I am a... *

Patient attended by Wiltshire and Bath Air Ambulance Charity

A family member of a patient

A bereaved relative or friend

Other

If other, please provide more information

Date of incident

Time of incident (if known)

Location of incident

Please tell us as much or as little about the incident as you feel comfortable doing

How can we help? If you have particular comments or questions for us please note them here.

Consent for storing submitted data *

Yes, I give permission to store and process my data

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