Virtual Patient Participation Group registration

Registered patient

I confirm that I am a registered patient at Mythe Medical Practice

Interest and availability

Why would you like to join the virtual PPG?

Are you able to participate in online surveys and polls?

Yes

No

Consent

I consent to my responses being used anonymously for the purposes of improving patient engagement and services

I understand my contact details will be stored securely in line with GDPR

Privacy note: Your personal information will only be used for managing your participation in the virtual PPG and will be stored securely in line with GDPR.

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Virtual Patient Participation Group registration

Interest and availability