Join the Patient Participation Group

If you are interested in becoming a member of our Patient Participation Group , please submit your details using the form below. Providing this information will help us to ensure that the PPG is as representative as possible of our practice population as a whole. The information you supply will be used lawfully, in accordance with the Data Protection Act 1998.

You will notice we are developing our Patient Participation Group to include a Bugbrooke Medical Practice Virtual Patient Participation Group.

The aim of the virtual PPG is to involve more people to have more say and to attempt to get a more diverse population involved with the group. The purpose of the group is to give patients the opportunity to provide regular feedback on the services they have received from the surgery, and to give an input into the future development of the practice. You will receive periodic surveys as a way to share your views. Our aim as a practice is to provide the best possible experience for all who visit our surgeries and to give our patients an opportunity to have their voice heard by being a member of the virtual group.

This is an exciting opportunity to get involved and we look forward to welcoming you on board to. If you are happy for us to contact you by email, please complete our online registration form below and we will be in touch soon via email.

Do you want to join:

Full name

Address

Postcode

Daytime Telephone Number

Mobile Telephone Number

Gender

Your Age Group

Your Ethnicity.

To help us ensure our group is representative of our local community please indicate which ethnic background you would most closely identify with:

How would you describe how often you come to the practice?

Do you have any experience which you can draw on and bring to a role in the PPG?

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to Bugbrooke Medical Practice • Levitts Road, Bugbrooke, Northampton, NN7 3QN.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

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