Join Our Virtual Patient Participation Group (VPPG)

The government is making changes to the way that GP practices work. Our services will be evolving in line with their guidance, but we would like feedback from our patients to ensure we continue to meet their needs.

As a member of our Patient Participation Group we would send you short surveys about specific proposed changes. We anticipate they will take no longer than five minutes to complete and return to us.

To join the group, please complete the form below. The easiest way to receive the questionnaires is by email but if you do not have access to email, we can post them to you.

Full Name*
Email Address*
Post Code*
Additional Information
This additional information will help to make sure we try to speak to a representative sample of the patients that are registered at this practice
Are you?*
- Male
- Female
- Prefer not to say
Age Group*
Ethnicity
To help us ensure our contact list is representative of our local community please indicate which of the following ethnic backgrounds you would most closely identify with?
Your Ethnicity
How would you describe how often you come to the practice?*
- Regularly
- Occasionally
- Rarely
Thank You
Please note that no medical information or questions will be responded to. The information you supply us will be used lawfully, in accordance with the Data Protection Act .The Data Protection Act 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.

Join Our Virtual Patient Participation Group (VPPG)

Additional Information

Ethnicity

Thank You

Helpful links

Further Info