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High Street, East Grinstead, West Sussex, RH19 3AATel: 01342 317 820 Email: firstname.lastname@example.org
This is a Patient Participation Group. The Practice enjoys a good relationship with this volunteer group and aims to facilitate its operation as much as possible. Whilst we have benefited enormously from the group’s generosity, with funds raised used to purchase equipment and toys etc for the Surgery, we also view the group’s existence as a channel for two-way communication between the Practice and the patients, for mutual benefit.
If you are interested in joining our group please contact the Chairman Paul Saffery via email email@example.com
This is a virtual group of patients who wish to participate in communication between the Practice and patients without having to attend meetings. If you wish to join this group, please contact the Chairman Paul Saffery via email firstname.lastname@example.org
We would like to know how we can improve our service to you and how you perceive our surgery and staff.
To help us with this, we are setting up 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 and people from non-British ethnic groups.
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.
Download the pdf version of our sign up form
We will be in touch shortly after we receive your form. Please note that no medical information or questions will be responded to.
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.
JUDGES CLOSE SURGERY
PATIENT PARTICIPATION GROUP
TERMS OF REFERENCE
Thank you for deciding to join the Judges Close Virtual patient Participation Group.
Here are our terms of reference.
Thank you for your involvement.
Judges Close Surgery hopes that all Group members and participants can equally benefit and enjoy meetings and events. This may be helped by the acceptance of a few “ground rules”.
Confidentiality must be respected; much can be learned through discussions and networking with other Group members and participants, but should be kept confidentially. Any breach of confidentiality will be viewed as a serious matter and may lead to an expulsion from the Group
Group members are asked to respect others by ensuring that they are on time for meetings and if a break has been called they reconvene at the time appointed
Whilst Judges Close Surgery has a responsibility to ensure that all meetings are as inclusive as possible, all Group members and participants should take responsibility for translating the policy into practice. Participants can make everyone feel involved by avoiding cliques, being friendly, particularly to new participants, and challenging behavior that contravenes this ‘code of conduct’.
When things go wrong
Judges Close Surgery acknowledges that sometimes things do go wrong. We would urge you to raise issues as soon as possible with us. If something happens that makes your full participation uncomfortable, difficult, or prevents you participating as fully as you would wish, please act immediately. Please talk to the Chair or the Practice Manager.
Contact the Patient Group with your feedback, suggestion, comment or question. Please do not use
this form for complaints - these should always be directed to the Practice Manager
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 to notify us of your comment.
Your IP address (184.108.40.206) will be sent
with your communication. In rare cases where abuse or criminal activity can be shown
to have taken place this may be used by the authorities to trace you.