The Gold Street Surgery - Join Patient Reference Group

Select Language
01799 525325
RSS
A A A

Useful Resources

BBC Health News

Liver transplant 'game changing' treatment approved16 Jan 2019 00:41It's hoped perfusion machines that "warm livers" will increase the number of viable donated organs.
What is the right age to lose your virginity?15 Jan 2019 00:40More than a third of women and a quarter of men think they got it wrong, research suggests.
Becca Henderson: Transplant hope for rucksack heart woman15 Jan 2019 10:27Scans show Becca Henderson has been clear of cancer for a year and is now eligible for a donor heart.
Breast cancer risk test 'game changer'15 Jan 2019 09:07GPs would use the online calculator to tell women their risk of getting breast cancer, say scientists.
Contact lens recycling scheme launched across UK15 Jan 2019 15:10The programme will give contact lens wearers the opportunity to recycle their lenses for free.
Lens replacement led to 'blind patches', says artist14 Jan 2019 05:00Landscape painter Denise De Batista is considering legal action against lens manufacturer Oculentis

Join Patient Reference Group

The Gold Street Surgery is in the process of establishing a Patient Reference Group (PRG) to gain the views of our registered patients and ensure they are involved in decisions about the range and quality of the services provided by our practice.

If you are interested in becoming a PRG member, please submit your details using the form below. Providing this information will help us to ensure that the PRG is as representative as possible of our practice population as a whole. The information you supply will be used lawfully, in accordance with the General Data Protection Regulation (GDPR).

Please select the practice location most relevant to this Online Form submission:

1 Your Details

Your name

Date of BirthPlease provide in the format dd/mm/yyyy

Are you able to provide your NHS or Patient Number?This will allow us to locate you quickly on our Patient Database.

NHS Number

E-mail Address

Postcode

Gender

Which of the following ethnic backgrounds do you most closely identify with?

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

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key known only to the GP practice and is accessed over a secure connection by nominated Practice staff. Our practice has a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to
Gold Street - Main Surgery • Gold Street, Saffron Walden, Essex, CB10 1EJ.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

Submit Form