The Gold Street Surgery - Join Patient Reference Group

Select Language
01799 525325
RSS
A A A

Useful Resources

BBC Health News

Instagram eating disorder content 'out of control'20 Mar 2019 17:00Psychiatrists raise concerns as the BBC finds children are swapping extreme images of weight loss.
Unprecedented drug shortage linked to Brexit, NHS bosses say20 Mar 2019 19:19Hospitals in England are experiencing a "spike" in medicine shortages, an NHS leader tells BBC Newsnight.
Potent cannabis increases risk of serious mental illness, says study20 Mar 2019 01:50People who use potent cannabis increase their risk of serious mental illness, according to researchers.
Childcare offered for free to smear-test mums20 Mar 2019 12:53Dozens of providers are offering an hour of free care so mothers can attend cervical screening appointments.
Parkinson's smell test explained by science20 Mar 2019 00:11A woman who can smell Parkinson's disease helps scientists discover what causes the musky odour.
San Francisco moves to ban e-cigarettes until health effects known20 Mar 2019 09:37The law would halt sales until vaping's health effects are fully evaluated by US regulators.

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