We welcome enquiries from patients who would like to join our patient group.

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Additional information

This additional information will help to make sure we try to speak to a representative sample of the patients that are registered at this practice.

Are you?

Ethnicity

To help us ensure our contact list is representative of our local community please indicate which of the following ethnic backgrounds you would most closely identify with?

How often would you say that you visit the practice?

Thank you

Please note that no medical information or questions will be responded to. 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.

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