We would like to know how we can improve our service to you and how you perceive our surgery and staff.
We have 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 around a hundred patients from as broad a spectrum as possible to get a truly representative sample. We need young people, workers, retirees, people with long term conditions,people from non-British ethnic groups we would hope that the PPG covers the diversity of our local area.
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.
Patient Reference Group Signup
BURNHAM SURGERY PPG - GROUND RULES
BURNHAM SURGERY PPG - TERMS OF REFERENCE
We will be in touch shortly after we receive your form. Please note that no medical information or questions will be responded to. If you wish to email the completed form to us please do so. Our email address is: email@example.com
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.