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Patient Participation Group registration

Patient Participation Group Registration
Please use this date format: DD/MM/YYYY
Responses we send will go to this email address
Are you:
How would you describe how often you come to the practice?
Ethnic Background:
Age group:
Would you be willing to join our PPG (Patient Participation Group)?
Would you like to receive the minutes of our meetings via email?
Would you like to receive our PPG newsletter via email?
Would you be interested in joining the ‘virtual’ PRG (Patient Representation Group), where you could contribute electronically?
Do you have a special interest in a particular medical condition?
Are there any issues you would like to see on the agenda?