Patient Group Expression of Interest

All registered patients, aged 16 and over, are welcome to get involved with the Patient Group. If you are interested in hearing about the Patient Group, the activities, to volunteer or would like to become a member please complete the form.

Patient Group Registration

Patient Group Registration

If you are human, leave this field blank.

Please input the details as used to register at the practice

Section

Ethnic Background:

White British

White Irish

White and Black Caribbean

White and Black African

White and Asian

Indian

Pakistani

Bangladeshi

Caribbean

African

Chinese

Other

This information will be used to measure whether the Patient Group members reflect the practice patient population

Age group:

16 - 24

25 - 34

35 - 44

45 - 54

55 - 64

65 - 74

75 - 84

Over 84

Would you like to join the virtual group?

Yes

No

As a “virtual” member, you will receive meeting agendas, minutes and updates about what the PG is doing. Your views and input are valued, whether by word of mouth or by email, plus you can also volunteer for events.

Are you interested in coming to the meetings?

Yes

No

These are held in person normally on a quarterly basis.

Would you be interested in becoming a Patient Group member?

Yes

No

These are elected roles and play an active part in in the meetings and arranging events to support the practice population.

Are you interested in volunteering to support PG activities?

Yes

No

These events cover helping marshal vaccine clinics, arranging health awareness events etc.