Dear Patient,

We would like to know how we can improve our service to you and how you perceive our surgery and staff. 

To help us with this, we are setting up a virtual patient reference group so that you can have your say. We will ask the members of this reference group some questions from time to time, such as what you think about our opening times or the quality of the care or service you received. We will contact you via email and keep our surveys succinct so it shouldn’t take too much of your time.

We aim to gather patient views from as broad a spectrum as possible to get a truly representative sample. We need involvement by young people, workers, retirees and people with long term conditions.

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

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