If you would like to become a member of our Patient Reference Group, please complete the form below.
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.
Colleagues in our partner Hampshire CCGs have asked if we could circulate this survey into the NHS111 service. They are looking at further developing the survey and are seeking patient views.
The West Hampshire Clinical Commissioning Group (CCG) have a number of surveys on their website. If you have experienced problems with ear wax, cataracts or knee pain, please see their survey. They would like to hear from you about the Extended hours hubs in your local area and if you have been referred to a hospital or other healthcare service.
The CCG are currently reviewing ophthalmology services for acute and chronic eye conditions. We would like to hear from patients who have experience of using hospital ophthalmology services, with a view to commissioning a community based service. If you have had experience of treatment for an eye condition please complete our survey below:
The information you supply us will be used lawfully, in accordance with the General Data Protection Regulations 2018. The General Data Protection Regulations 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.