patient survey

Virtual Patient Reference Group (VPRG)

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

We understand that not everyone can attend our Patient Reference Group Meetings held here at the surgery, but still wish to have a say in what we do. 

To improve services we give to our patients, the VPRG will be for you to share your comments and to help us.  Contact will be made by email only.  

From time to time we will be asking members of the VPRG, some questions about how to improve services and what areas we should be focusing etc. We will keep our surveys short as possible so not to take up too much of your time.  

Your input and thoughts are very important and hope that the VPRG will allow you to have an influence and a voice to express your views on how the pratice is doing and how we can improve services. 

We aim to gather around a hundred patients from as broad a spectrum as possible to get a truly representative sample. We need young people, workers, retirees, people with long term conditions and people from non-British ethnic groups. Along with patients who use our surgery frequently and those who do not.

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 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 form 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.
































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