Patient Participation Group Registration

If you have not registered to be a member of our Patient Group then we would welcome you to sign up now.

Alternatively, you can download this form and bring it to reception

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?
Your application will be provided to the current PPG members for review, please confirm below that you are happy for this to happen.