Desborough Surgery

01494 526006

Hazlemere Surgery

01494 711954

Join our PPG

Would you like to have a say about the services provided at Desborough and Hazlemere Surgeries

Desborough and Hazlemere Surgeries would like to hear your views.

By providing your email details we can add them to a contact list that will mean we can contact you by email every now and again to ask you a question or two.

Fill in the details below and we will add your email address to a contact list.

Please ensure that you complete all fields marked with an * otherwise the form cannot be sent.

Join our PPG

Patient participation group recruitment form
  • Additional information

    This additional information will help to make sure we try to speak to a representative sample of the patients that are registered at this practice.
  • Ethnicity

    To help us ensure our contact list is representative of our local community please indicate which of the following ethnic backgrounds you would most closely identify with?
  • Level of involvement with PPG

  • Thank you

    Please note that no medical information or questions will be responded to. 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.
  • Section Break

  • This field is for validation purposes and should be left unchanged.