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St Luke's Primary Care Centre Providing NHS services
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Home > Patient Participation Group Form

Patient Participation Group Form

Please note:

  • No medical information or questions will be responded to.
  • Individual complaints cannot be dealt with through the Patient Group.

Complaints should be addressed to the Practice Manager.

Copies of our complaints procedure can be requested from the practice.

Please be assured that your contact details will be kept safely and securely, and not shared with anyone else.

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.

Patient Participation Group Form

I would like to join the:

Patient Participation Group
Patient Reference Group
Age Group

Ethnic Origin - I would describe my ethnic origin as follows: (please tick as appropriate)

White
Mixed
Asian or British
Black or Black British
Chinese or other Ethnic Group
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 and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

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.


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St Luke's Primary Care Centre

Timken Way South, Duston, Northampton, NN5 6FR

  • 01604 587918
  • northantsicb.contact.stlukesduston@nhs.net
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Local Services
Skin Tag
Removal
Massage
Therapy
Hearing Aids
& Services
Optician
Double Glazing