In addition to our Patient Group (which meets face to face) we have a Virtual Patient Reference Group.
We would like to recruit patients for our reference group from as broad a spectrum as possible to get a truly representative sample. We need young and old patients, patients that work, patients that don't work, patients that care for others, patients with long term conditions and patients from non-British ethnic groups.
If you have an e-mail address and are happy for us to contact you occasionally by e-mail please click the link below to open the sign-up form and complete all the fields. Thank you.
Complete the Virtual 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.