Patient Participation Group Registration

We are currently investigating the setting up of a virtual patient reference group and if you would be interested in joining this, please complete the form below. We will be in touch shortly after we receive your form. We are keen to get patients of all ages (over 16) and of varying ethnic groups to join the “virtual” panel so if you are willing to get involved we shall look forward to hearing from you.

Patient Participation Group Registration

Patient Participation Group Registration

Section

How would you describe how often you come to the practice?
Ethnic Background:
Age group: