Your Practice needs you!

Would you like to become a member of the West Byfleet Health Centre's Patient Participation Group?

Reasons for joining:	Forum for feedback of views Involving you in planning and developing new services Improve the quality of service Improve facilities

Why Not Join Us?

complete and submit this form

Surname:           *                         * boxes must be completed

First Name:         *

Date of Birth:      *

Home Address:

Email Address:   *

Telephone No:   *

Select your Practice:      Dr Lynch and Partners Parishes Bridge Medical Practice Wey Family Practice

CONFIDENTIALITY - TERMS AND CONDITIONS:

The Internet is not secure and the transmission of data is entirely at the patient's own risk.  The Practices accept no responsibility for breaches in confidentiality resulting from patients' transmissions.

* I accept the terms and conditions above (must be ticked)