Join our PPP

Would you like to have a say about the services we provide?

The Pinhoe and Broadclyst Medical Practice wants to hear your views.

The Practice has had a Patient Panel (PPP) for some years. This was initially a ‘virtual’ group, seeking and receiving patients’ views by email. Since January 2016 we have also started meeting here at the Surgery every 2 months. Patients are very welcome to become or remain as ‘virtual’ members and we will contact you, via email, no more than 5 times a year, to ask for your views and update you. Alternatively all PPP members are invited to attend any or all of our meetings.

Questions/enquiries might be about:

The services we provide and any proposed changes.
Setting our priorities for the future.
Helping to agree questions for wider patient surveys.

If you want to help, please fill in the details below and we will add your email address to our contact list.

Patient participation group recruitment form

Name*
Email address*
Enter Email Confirm Email
Post code*
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?*
- Male
- Female
Age group*
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?
What is your ethnicity?*
How would you describe how often you come to the practice?*
- Regularly
- Occasionally
- Very rarely
It is important that the Patient Participation Group represents all patients and does not become a place to air personal grievances.
Therefore we would ask that you agree our Code of Conduct for the Group.
Please read the Code of Conduct document linked here
I have read and agree to abide by the PPP Code of Conduct*
- Confirm
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.
Phone
This field is for validation purposes and should be left unchanged.

Would you like to have a say about the services we provide?

Join our PPP

Additional information

Ethnicity

Thank you

Helpful links: