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Dear Patient,

patient surveyWe are interested to know how we might improve our service to you and how you perceive our surgery and staff. 

To help us with this, we have a patient representation group so that you can have your say. We might ask the members of this group some questions from time to time, such as what you think about the quality of the care or service you receive or about our clinic times.  Contact would usually be via email and questions or surveys would be succinct so it shouldn’t take too much of your time.  You would of course also be welcome to attend any group meetings that might be arranged

We aim to gather a representative number of patients from as broad a spectrum as possible.  So whatever your age, status, ethnic origin or health condition please let us know if you might be interested in becoming a part of this group.  If you wish to register your interest, please complete the form by following the link below.  We will respond as soon as possible.

If you become part of the group we would use the e-mail address you give us to contact you from time to time.  Please click the link below to open the 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


Please note that no medical information or questions can 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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