Dear Patient,

We are considering setting up a patient representation group, this will be an additional way that you can feedback to the Practice any ideas you may have.  We will ask the members of this representative group some questions from time to time, such as what you think about our opening times or the quality of the care or service you received. We will contact you via email in the first instance and keep our surveys succinct so it shouldn’t take too much of your time.

We aim to gather a broad a spectrum of registered patients as possible to get a truly representative sample so hopefully you will want to get involved. 

Once we have sufficient numbers our Patient Participation Group can launch.

If you are happy for us to contact you occasionally by email please click the link below to open the sign-up form and complete all the fields.

Complete the Patient Group Sign-up Form Online

If you prefer, you can download the sign up form as a pdf document, print it out, complete it and return it to the practice.

Download the pdf version of our sign up form

We will be in touch shortly after we receive your form. Please note that no medical information or questions will be responded to.

Many thanks for your assistance

The information you supply us will be used lawfully, in accordance with the Data Protection Act 1998. The Data Protection Act 1998 gives you the right to know what information is held about you and sets out rules to make sure that this information is handled properly.