Join The Patient Participation Group

Thank you for your interest in joining our PPG. Please complete the below information and someone will be in touch. 

  • Your Details

    Date of birth
    For example, 15 3 1984

  • Your Details - Continued

    The information below will help to make sure that we receive feedback from a representative sample of the patients registered at the practice.

    Gender
    Age Range:
    Ethnicity
    How often do you visit the practice?
The information you provide on this form will be sent to our practice and used only to deal with your request. Depending on the form, this may include your contact details, personal information and health information. The practice may add it to your medical record and, where needed for your care, share it with other NHS and care services. To find out how we protect and use your information, please read our privacy policy on our website.
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Page last reviewed: 12 February 2024
Page created: 02 October 2026