Patient Participation Group Registration

All registered patients are welcome to attend any meeting of the Patient Participation Group without giving prior notice. If you are interested in hearing about the activities of the Patient Participaton Group but cannot/do not want to attend meetings please complete the form below to receive newsletters and invitations to contribute to the group activities online.

If we need to contact you regarding the submission of your form, we may respond directly through the website and aim to do this within 5 working days of receipt of your form. You will be notified of any responses via email. Please remember to check your email account’s spam/junk folder.

Patient Participation Group Registration

Patient Participation Group Registration

Please use this date format: DD/MM/YYYY
Responses we send will go to this email address
Are you:
How would you describe how often you come to the practice?
Ethnic Background:
Age group:
Would you be willing to join our PPG (Patient Participation Group)?
Would you like to receive the minutes of our meetings via email?
Would you like to receive our PPG newsletter via email?
Would you be interested in joining the 'virtual' PRG (Patient Representation Group), where you could contribute electronically?
Do you have a special interest in a particular medical condition?
Are there any issues you would like to see on the agenda?
*