Patient Participation Group
Approximately 2% of patients are members of the patient participation group.
A range of ages are represented, men and women and patients with various health needs, such as chronic diseases, hearing impairment, visual impairment and mobility problems.
We have also tried to include working, non-working and retired patients.
Approximately 12% of the group are from ethnic minorities.
The practice is always keen to hear from practice patients regarding the running of the practice and any improvements that may be made. If you are a registered patient and wish to contribute to the patient participation group, please download and complete the form below and leave at reception or email to email@example.com. Alternatively hard copies are available at reception.
Please note that this email address should not be used for any concerns regarding a medical problem.
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.