Show Side Menu

Join Patient Reference Group

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 representation group so that you can have your say. We will ask the members of this representative 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 around a hundred patients from as broad a spectrum as possible to get a truly representative sample.  To join the group you can either complete the online form at the end of this page or click here to download the form.  If you download the form please return the completed form to the surgery.

Common questions & answers

Why are you asking patients for their contact details?

We would like to be able to contact patients and carers occasionally to ask them questions about the practice and how well we are doing to identify areas for improvement

Will my doctor see this information?

This information is purely to contact patients to ask them questions about the practice, how well we are doing and ensure changes that are being made are patient focused. If you doctor is responsible for making some of the changes in the practice they might see general feedback from patients.

Will the questions you ask me be medical or personal?

We will only ask general questions about the practice, such as short questionnaires.

Who else will be able to access my contact details?

Your contact details will be kept safely and securely and will only be used for this purpose and will not be shared with anyone else.

How often will you contact me?

Not very often. We plan to contact our group four times a year.

What is a patient group/patient participation group?

This is a group of volunteer patients who are involved in making sure the practice provides the services its patients need.

What if I no longer wish to be on the contact list or if I leave the practice?

We will ask you to let us know by email if you do not wish to receive further messages.

Your Details
Please provide in the format dd/mm/yyyy, for example 18/01/1970
This will allow us to locate you quickly on our Patient Database.

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key known only to the GP practice and is accessed over a secure connection by nominated Practice staff. Our practice has a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.


Your Neighbourhood Professionals. Just a Click Away!
OTTiCA PROCiDA Bukky Oluonye