icon

Patient Participation Group

We have an active Patient Participation Group and a Virtual Patient Group. If you would like to join the group and be involved in sharing views from a patient's perspective, please fill the form below.

Your contact details will only be used for this purpose and will be kept safe.

Registration Form

(by providing this number you are consenting to us contacting you by text if necessary)
Are you male or female?  
What age are you?  
Which of the following best describes your ethnic background?  
Please Specify  
How would you describe how often you come to the practice?  
Are you a parent/guardian of a child under 18 years of age?  
Do you consider that you have a disability?  

The information you supply us will be used lawfully, in accordance with the Data Protection Act 2018. The Data Protection Act 2018 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.

Fields marked with an asterisk (*) are mandatory