Join our PPG and our Primary Care Network Patient Group

West Timperley Medical Centre patient group: we welcome enquiries from patients who would like to join our group.If you would like to join our Patient Participation Group, please follow this link to complete our online form.

Altrincham Healthcare Alliance Primary Care Network patient group: we would welcome your views on our work across the five practices. If you would like to be involved please send your details (including your name, preferred contact details, GP practice name, plus a brief description of why you would like to be part of our Primary Care Network Patient Participation Group) via email to [email protected] Alternatively contact your GP practice reception for further details. For more information please click here

Name*
Email address*
Post code*
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.
Are you?*
- Male
- Female
Age group*
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?
What is your ethnicity?*
How would you describe how often you come to the practice?*
- Regularly
- Occasionally
- Very rarely
Consent*
By submitting your details you are consenting to providing this information for improving our services to you. The data you supply on this form will be securely stored on our website, which is hosted by a third party. We will retain this information on the website for no longer than 7 calendar days. Your contact details will not be sold or shared with a third party. I understand I can revoke this consent at anytime by contacting the practice. Our privacy policy can be viewed on this website.
I agree to the privacy policy.
Thank you
Email
This field is for validation purposes and should be left unchanged.

Join our PPG and our Primary Care Network Patient Group

Additional information

Ethnicity

Thank you

Helpful links

Further Info