The Harlequin Surgery, 160 Shard End Crescent, Shard End, Birmingham, B34 7BPTel: 0121 747 8291
What is a Patient Reference Group?
This is a group of patients working with a practice to:
If you are happy for us to contact you 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
It is important you understand that this group will not be a way of complaining about the services we provide or the treatment you are receiving. If you have a complaint about this you must follow the usual procedure.
You may leave this group at any time by emailing firstname.lastname@example.org
To see the Patient Participation Group members profiling information please click here
25th April 2018
To view our recent PPG Report and Action Plan please click below. PPG Report and Action Plan 2014/2015(this will open in a word document)
PPG Report and Action Plan 2013/2014(this will open in a word document)
PPG Report 2012/2013(this will open in a word document)
Action Plan 2012/2013(this will open in a word document)
PPG Report 2011/12(this will open in a word document)
PPG Action Plan 2011/12(this will open in a word document)
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 (126.96.36.199) 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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