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Borehamwood Shopping Park
Borehamwood
Herts, WD6 4PR

Patient Participation Group

Dear Patient,

We would like to know how we can improve our service to you and how you perceive our surgery and staff.

To help us with this, we are setting up a virtual patient representation group so that you can have your say. We will ask the members of this representative group some questions from time to time, such as what you think about our opening times or the quality of the care or service you received. We will contact you via email and keep our surveys succinct so it shouldn’t take too much of your time.

We aim to gather members from as broad a spectrum as possible to get a truly representative sample. We need young people, workers, retirees, people with long term conditions, carers and people from non-British ethnic groups.

If you are happy for us to contact you occasionally by email please complete the sign-up form below.

 Name
 
 Postcode
 
 Email address
 
 Mobile number
 

To show you are human please complete the following:
3 + 1 =

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.

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