Patient Participation ‘Virtual’ Panel (PPVP)

We are looking for a representative group of patients that we can interact with through our Patients Forum when we have questions or ideas about the future direction of the practice.  If you would like to be included in this panel, you will receive quarterly newsletters from us during the year highlighting the topics discussed on the Patients Forum.  If you wish to be involved please leave your details with reception.

If you are happy for us to contact you occasionally by email please click the link below to open the sign-up form and complete all the fields.

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.