Birchwood Practice Contact
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PATIENT PARTICIPATION GROUP
Name:
 
Email:
Postcode*
The information below will help to make sure that we receive feedback from a representative sample of the patients registered at this practice.
Please choose as appropriate. Thank you.
Your Gender*
Your Age Group*
The ethnic background with which you most closely identify is:
Your Ethnic
Background
Please list any areas that you would like to see surveyed:
Please note that we will not respond to any medical information or questions received through the survey.
* Details optional.
We are encouraging patients to give their views about how the practice is doing. We would like to be able to find out the opinions of as many patients as possible and are asking if people would like to provide their email addresses so we can contact you by email every now and again to ask you a question or two.

If you are interested please could you fill in this online form and we will add your email address to our contact list. Alternatively, you can phone the practice with your details. Your contact details will only be used for this purpose and will be kept safely.

FREQUENTLY ASKED QUESTIONS:

Why are we asking people for their contact details? We would like to be able to contact people to ask questions about the surgery and how well we are doing to identify areas for improvement?

Will my doctor see this information? No. This information is purely to contact patients to ask them questions about the surgery, how well we are doing. Your doctor will only see the overall results.

Will the questions you ask me be medical or personal? We will only ask general questions about the practice, how we are proving services and what we can do to improve those services.

Who else will be able to access my contact details? No-one beyond the Practice. 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 his information is handled properly.

How often will you contact me? Not very often.

What is a patient representative group? This is a group of volunteer patients who are involved in shaping the services available to patients.

Do I have to take part in the group? No, but if you change your mind, please let us know.

What if I no longer wish to be on the contact list or I leave the surgery ? We will ask you to let us know if you do not wish to receive further messages.

Who do I contact if I have further questions? The Practice Manager.

Patient Participation Group
Comments & Suggestions

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