Lawson Practice Patient Participation Group Interest Form

Would you like to have a say about the services provided at Lawson Practice? The Lawson Practice would like you to join our Patient Participation Group to hear your views. By providing your 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.

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Name *
Email address
Postcode *

To help us ensure our contact list is representative of our local community please indicate which if the following ethnic background you would most closely identify with? 

*

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

*
Thank you.

The information you supply us with will be used lawfully, in accordance with the Data Protection Act 1988. The Data Protection Act 1988 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.

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