Patient Participation Group
We are keen for patients to join our Patient Participation Group (PPG).
If you would like to join the Kirkley Mill Surgery PPG to enable you to have your opinion in how your practice develops please email firstname.lastname@example.org.
Patient involvement in health is currently a high priority in the NHS. With the transition to GP commissioning this will become more and more important to practices.
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.
Complete the Patient Group Sign-up Form Online
If you prefer, you can download the sign up form as a pdf document, print it out, complete it and return it to the practice.
Download the pdf version of our 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.