THE ALL NEW NHS
DIRECTORY OF SERVICES!
virtual Patient Participation Group (vPPG )
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.
Please click on the link below to fill out our Patient Group Survey.
Please email back to MERCCG.firstname.lastname@example.org or print and hand in at Reception.
Contact the Patient Group with your feedback, suggestion, comment or question. Please do not use
this form for complaints - these should always be directed to the Practice Manager
Note that by using this form, you will be sending information about yourself across
the Internet. Whilst every effort is made to keep this information secure, you should
be aware that we cannot offer any guarantees of absolute privacy. If this matter
concerns you then you should use another method to notify us of your comment.
Your IP address (184.108.40.206) will be sent
with your communication. In rare cases where abuse or criminal activity can be shown
to have taken place this may be used by the authorities to trace you.
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