This website uses cookies to function correctly.
You may delete cookies at any time but doing so may result in some parts of the site not working correctly.

Patient Reference Group

PPG Poster

We have a Patient Reference Group so that we can get the views of a representative group of patients on what they regard as priority issues for change/development within the practice. This may be about the services we provide, how we provide them or even services that you would like us to provide (subject to funding of course!) either within the practice or within the North Bournemouth locality.

 

We identify from the group the areas/issues that they feel are a priority, carry out a survey within the group (on the issues identified) and, from the feedback, develop an action plan.

 

As we are aware of the pressures on everyone’s time, we make this as easy as possible and to communicate with the group via email (or letter if you do not use email). This is usually around 2-3 times in the year. The identity of the members of the group will be known only to the practice.

 

If you are interested in participating in the practice in this way complete the form below and return it to me? If you would like to discuss this further before deciding, please just give me a call.

 

Matthew Haden

Practice Manager

01202 574604

 

PATIENT REFERENCE GROUP 

 If you would like to join this group (communication will be by email or, if you don’t have an email address, by letter) please complete the form below and hand in to reception.


Name:

 

………………………………………………………………….


Email Address:

 

………………………………………………………………….


Postcode:

 

………………………………………………………………….

 

The information below will help to make sure that we receive feedback from a representative sample of the patients registered at this practice.  Please tick as appropriate.  Thank you.

 

Your Gender:

Male                           

Female

Your Age:

Under 16

25 – 34

45 – 54

65 – 74

17 – 24

35 – 44

55 – 64

75 – 84

Over 84

Are you employed/unemployed ? (Please delete as appropriate)

If employed, what type of work do you do?

 

The ethnic background with which you most closely identify is:

White

 

British Group

Irish

Mixed

 

White & Black Caribbean

White & Asian

 

White & Black African

Asian or Asian British

 

Indian
Bangladeshi

 

Pakistani

Black or Black British

 

Caribbean

African

Chinese or Other

Chinese

 

Any Other

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

Regularly

 

Occasionally

 

Very rarely

 

Please list any issues that you feel are a priority:

 

 

 

 

………………………………………………………………………………………………………………………………………………………………………

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 the Data Protection Act 1998.

 

 



Call 111 when you need medical help fast but it’s not a 999 emergencyNHS ChoicesThis site is brought to you by My Surgery Website