Virtual Patient Participation Group Registration

We are restarting our PPG we are looking for new representatives.

All registered patients over 16 years old are welcome to be involved in the Virtual Patient Participation Group.

Ideally, we would like to have a cross section of patients joining our group. This would enable us to have a true representation of our patient’s views.

We will work together with mutual respect, openness, and trust. Your views are important and will be listened to.

If you are interested in learning more about our Virtual Patient Participation Group, receiving occasional emails, surveys, please complete the online form. Alternatively, you can ask us about it when you next visit the practice.

Please Note – PPG is not a forum to raise individual complaints or seek medical advice.

Patient Participation Group Registration

Patient Participation Group Registration

If you are human, leave this field blank.

Full Name: *

Postcode:

Phone Number: *

Email Address: *

Any responses we send will go to this email address.

Are you:

Male

Female

How would you describe how often you come to the practice?

Regularly

Occasionally

Very rarely

Ethnic Background:

White British

White Irish

White and Black Caribbean

White and Black African

White and Asian

Indian

Pakistani

Bangladeshi

Caribbean

African

Chinese

Other

Age group:

Under 16

17 - 24

25 - 34

35 - 44

45 - 54

55 - 64

65 - 74

75 - 84

Over 84