Go Team

Patient Participation Group 

Would you be interested in joining our 'Virtual' Patient Participation Group? 

In order to help us improve services we need your help and feedback.   Your role could help influence and develop future local services.

Due to no meeting space available at both Scots Gap and Stamfordham sites we are a virtual group.  This means that our method of communication is via email.  From time to time we may contact you asking you a question or two and get your views and opinions on our services. 

             If you are interested please complete the form below or contact us at: norccg.scotsgapsurgeryadmin@nhs.net 

About This Form

Some fields on this form are compulsory.

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.

Signing Up For Patient Reference Group


If you are happy for us to contact you periodically by email please fill out all the fields below and send the completed form to us.

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

Thanks for submitting!