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 reception.
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 email@example.com
To see the Patient Participation Group members profiling information please click here
To ensure that our PRG is representative of our registered patients we regularly send out invitations to patients selected at random who fit a category that is not yet represented to join our group.
If you feel you know anyone who might be interested in joining our PRG please ask them to contact us via the 'contact tab' at the top of this page.