Patient Participation Group
We would like to hear your views on how we can improve services. You can have your say by becoming part of Dr Shakarchi's Practice Virtual Patient Participation Group.
We realise that people are generally very busy and may not have time to come to the practice for meetings. We would like to form a "virtual group" that can exchange views, participate in practice surveys and with whom we can consult from time to time by e-mail. However if you don't have an email address you can still get involved, the only stipulation is that you are a patient at Dr Shakarchi's Practice.
If you are happy for us to contact you occasionally by email please click the link below to open the sign-up form and complete all the fields.
Complete the Patient Group Sign-up Form Online
If you prefer, you can download the sign up form as a pdf document, print it out, complete it and return it to the practice.
Download the pdf version of our sign up form
We will be in touch shortly after we receive your form. Please note that no medical information or questions will be responded to.
Many thanks for your assistance
The information you supply us will be used lawfully, in accordance with the Data Protection Act 1998. The Data Protection Act 1998 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.