PPG/PRG Registration

Registration Forms

All registered patients are welcome to express an interest in joining the Patient Participation Group by submitting this form. With your agreement, your name and telephone number will be passed to the Chairperson of the Patient Participation Group who will contact you to give further information and if you are interested in joining, the Group will make arrangements for you to attend the next meeting.

In addition to our Patient Participation Group we have a Patient Reference Group (PRG) and are always looking to recruit patients who would like to play an active part in helping to make decisions about the range and quality of services we offer.

This is a ‘virtual’ group which means most communication is carried out by e-mail, thus allowing members to contribute to discussions within their own time. We encourage patients to give their views about how the practice is doing and would like to be able to ask the opinions of as many patients as possible. If you are interested in joining our Patient Reference Group, please submit this form.

Patient Participation Group Registration

Title
Email
Date of Birth
The information below will help to make sure that we receive feedback from a representative sample of the patients registered at this practice.
Gender
Your Age
How would you describe how often you come to the practice?

Patient Reference Group Registration

Title
Email
Date of Birth
The information below will help to make sure that we receive feedback from a representative sample of the patients registered at this practice.
Gender
Your Age
How would you describe how often you come to the practice?