So that we can make sure that the information we send you (such as invitations to events meet your needs) please indicate below if you have any communication or access needs?
The Patient Participation Group (PPG) is a group of patients registered with your GP surgery who represent patient views.
We would like to find out this information, as our Commissioners sometimes ask us to contact people on our database for views on specific health topics and this information will assist us.
To help us send the most relevant information, please select the areas that are most important to you:
The questions in this section are for monitoring purposes only:
To help us ensure that your language or interpretation needs are catered for, please advise the following:
Language (please advise your first language)
The information that you provide on this form will be used by the Black Country and West Birmingham CCG to contact you about local healthcare services, activities and to inform you of events being run by our partner agencies.
Your details will only be used for this purpose and will not be shared with anyone else. The information you supply will be held securely and in accordance with the Data Protection Act 1998. You can opt out of the membership scheme at any time by emailing the Engagement Team at any time on firstname.lastname@example.org or by calling 0121 612 1447. We will contact you for your consent if there are any changes to the way in which your information is used.
Telephone Number: 0121 612 1447