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 Participation 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.

Patient Participation Group Registration
If you would like to be involved, please fill in your email address below and answer a few questions about yourself.
Any responses we send will go to this email address.
Are you: *
How would you describe how often you come to the practice? *
Which Patient Group are you interested in registering? *
Ethnic Background: *
To help us ensure our contact list is representative of our local community please indicate which if the following ethnic background you would most closely identify with?
Age group: *
I give my consent for SMS text messaging *

Declaration

I would like to be involved in the Patient Participation Group (PPG) and or the Patient Reference Group (PRG) and give consent for the GP Practice to contact me by e-mail (or post, if applicable). I can leave this group at any time by notifying the practice. I can remain a member of this group only while I am a registered patient of the practice. I agree to attend at least two thirds of all Patient Participation Group meetings including the AGM (not required for PRG).
The information you supply us with will be used lawfully, in accordance with the Data Protection Act 1988. The Data Protection Act 1988 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.

Please note that no medical information or questions will be responded to.