Join our PPG

We welcome enquiries from patients who would like to join our patient participation group (PPG).

Please complete the form below or alternatively you can download a form here and return it to the surgery.

Please note! This is not a New Patient Registration form! 

About you

Full name(Required)
Email address(Required)

More about you

This additional information helps us ensure that we speak to a representative sample of the patients registered at the practice.
Would you describe yourself as(Required)


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?
Not for urgent medical help(Required)
This field is for validation purposes and should be left unchanged.

Date published: 13th October, 2014
Date last updated: 20th November, 2023