Tab 1

Contact Us

Contact the Patient Group with your feedback, suggestion, comment or question. Please do not use
this form for complaints – these should always be directed to the Practice Manager

Your Contact Details:


About This Form

Note that by using this form, you will be sending information about yourself across
the Internet. Whilst every effort is made to keep this information secure, you should
be aware that we cannot offer any guarantees of absolute privacy. If this matter
concerns you then you should use another method to notify us of your comment.

Your IP address () will be sent
with your communication. In rare cases where abuse or criminal activity can be shown
to have taken place this may be used by the authorities to trace you.

Tab 2

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