Dear Patient,
We would like to know how we can improve our service to you and how you perceive our surgery and staff.
To help us with this, we have set up a virtual patient representation group so that you can have your say. We ask the members of this representative group some questions from time to time, such as what they think about our opening times or the quality of the care or service they received. If you become a member of this group we will contact you via email and keep our surveys succinct so it shouldn’t take too much of your time.
We currently have around twenty patients actively involved in our patient group and are keen to invite more patients to join in. Ideally a hundred patients from as broad a spectrum as possible to get a truly representative sample would be good. We need young people, workers, retirees, people with long term conditions and people from non-British ethnic groups to take part in this group.
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.