Patient Participation Group- Expression of interest form (1)

About the PPG

Our PPG supports the practice by:

Gathering patient feedback to help improve services
Acting as a “critical friend”—offering honest but constructive feedback
Strengthening communication between patients and the practice
Sharing information about local support groups and services
Promoting health awareness and self-care
Supporting NHS teams with feedback on local needs
Connecting with other local PPGs and community networks

We work on the founding principles of mutual respect, trust, equality, active listening, and honest communication.
The PPG is not a complaints forum or fan club, but a patient-led, constructive, and action-focused group.

Your Details

What is your preferred method of contact *

Phone

Post

Name *

Phone Number

Email Address *

About You

Why would you like to join the PPG? (What interests or motivates you about being involved?) *

What skills, knowledge or experience could you bring to the group? (This could include personal, professional or community experience)

Do you have any particular areas of interest? (e.g. digital access, patient communication, health promotion, accessibility, community outreach)

Are you currently involved in any local community or volunteer groups? If yes please tell us a little about them.

How much time would you be able to give to PPG activities? Meetings are usually every 6-8 weeks with optional involvement in specific projects or events. *

Equality & Inclusivity

We aim to ensure our PPG reflects the diversity of our practice population.

If you’d like, you may tell us a bit about yourself (for example, age group, background, or any accessibility needs) to help us ensure inclusive participation.

Next Steps

Once we’ve received your form, we’ll get in touch to discuss the next steps and let you know about upcoming meetings or opportunities to get involved.

Thank you for your interest – your voice can make a real difference.

THIS FORM COLLECTS YOUR NAME, DATE OF BIRTH, EMAIL, OTHER PERSONAL INFORMATION AND MEDICAL DETAILS. THIS IS TO CONFIRM YOU ARE REGISTERED WITH THE PRACTICE, TO ALLOW THE PRACTICE TEAM TO CONTACT YOU AND ALSO TO UPDATE YOUR MEDICAL RECORDS HELD BY THE PRACTICE AND OUR PARTNERS IN THE NHS. PLEASE READ OUR PRIVACY POLICY TO DISCOVER HOW WE PROTECT AND MANAGE YOUR SUBMITTED DATA. *

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Page last reviewed: 28 November 2025

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