PPG expression of interest form Expression of Interest for our Patient Participation Group. Enter your name
E-mail address
Telephone / mobile no
Postcode
The information below will help to make sure we receive feedback from a representative sample of the patients registered at Moir Group of Surgeries. Your gender Your age The ethnic background you most closely identify with is: How would you describe how often you attend the practice? Thank you for expressing your interest to join our Patient Participation Group. Please note, no medical queries or information received via this form will be responded to.
The information you provide us with 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 this information is handled correctly.