PPG Registration Form

PPG Registration Form

Patient Participation Group Registration Form

If you are interested in joining our Patient Participation Group please complete the registration form.

We are a ‘virtual’ group and communicate via email ( or post if you do not have an email address).  We do not expect you to attend meetings, but we contact members from time to time to ask for your opinions and advice on the provision of health services at Manor View Practice.  We need young people, workers, retirees, people with long term conditions and people from non-British ethnic groups to cover as broad a spectrum of patients as possible.  You may also contact us if you have a query or suggestion to share with the group.

    Personal Details

    MrMrsMissMsDrOther
    Under 1617-2425-3435-4445-5455-6465-7475-84Over 85
    RegularlyOccasionallyVery Rarely

    Please note that we will not respond to any medical information or questions received through the survey.

    The information you supply us will be used lawfully, in accordance with GDPR Regulations. GDPR 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.

    Please note that by using this form you will be sending information about yourself across the Internet. Whilst every effort is made to keep this information secure, you should be aware that we cannot offer any guarantees of absolute privacy. If this matter concerns you then you should use another method of registration.

    Personal information retained on this system is stored in a secure data centre located in the UK and is treated as confidential.