Are you interested in finding out more about your Surgery?
Would you like to influence the development of local health services?
We are keen to set up a “virtual” Patient Group to discuss these issues. You will not need to attend any meetings, just give us feedback by completing a survey from time to time. It does not need to be a long-term commitment and you can choose to leave the group at any time.
If you have any queries please ask the receptionist for more information or contact Pernie Barlow, HR Manager on 01306 881313.
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.