Sign Up For Our Patient Survey

Dear Patient,

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

To help us with this, we are setting up a virtual patient representation group so that you can have your say. We will ask the members of this representative group some questions from time to time, such as what you think about our opening times or the quality of the care or service you receive. We will contact you via email and keep our surveys succinct so it shouldn’t take too much of your time.  We have also set up a discussion forum forum for you to have your say.

We aim to gather around a hundred patients from as broad a spectrum as possible to get a truly representative sample. For this to happen, the group should include young people, workers, retirees, people with long term conditions and people from non-British ethnic groups.

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.

Patient Survey 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.