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Patient Grouppatient survey

Your views are important to us and we would like to involve you in the future of your surgery. Once a quarter we hold “Patient Reference Group” meetings so we can share ideas with you. If you would like to join these meetings please leave your details with reception and we will contact you.

Alternatively please leave your e-mail address if you would like to be a virtual member, so we can e-mail you for your feedback on things like planned developments or improvements on our patient survey.

If you are happy for us to contact you occasionally by email please click the link below to open the sign-up form and complete all the fields.

complete the form Complete the Patient Group Sign-up Form Online

If you prefer, you can download the sign up form as a pdf document, print it out, complete it and return it to the practice.

download the pdf form Download the pdf version of our sign up form 

We will be in touch shortly after we receive your form. Please note that no medical information or questions will be responded to.

Many thanks for your assistance


The information you supply us will be used lawfully, in accordance with the Data Protection Act 1998. The Data Protection Act 1998 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. 

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