Ball Tree Patient Voice Reference Group

Would you be interested in helping us in future as part of a Patient Voice reference group?

This would involve occasional requests to answer short questionnaires via email / you letting us know your thoughts about what we can do to improve our services.

We might also ask you to pilot services / consider our ideas and plans for developing the surgery / look at patient letters / advice sheets etc.

We think that this would mostly by email and phone, but it could also involve occasional meetings in person.

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* 1. Would you like to join Ball Tree Patient Voice Reference Group?

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* 2. How do you describe your Ethnicity e.g. White / Black / Asian

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* 4. Please let us know your name, date of birth and email / number.

Your Name (First Name, Surname)

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* 5. Your Date of Birth

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* 6. Your mobile telephone or landline number

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* 7. Your email address

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