PATIENT REFERENCE GROUP
MEMBERS WANTED
TO JOIN OUR
PATIENT REFERENCE GROUP
Ø Are you interested to learn more about the changes in the NHS and how these may affect you as patients?
Ø Would you like to pro-actively contribute to the development of services in the practice?
Ø Would you like to support the commissioning of health services for the wider population?
IF THE ANSWERS TO THESE QUESTIONS IS YES PLEASE COMPLETE A SIGN UP 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 version of our sign up form
We will be in touch shortly after we receive your form. Please note that no medical information or questions will 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.