Join Patient Reference Group

St Wulfstan Surgery has an established Patient Reference Group (PRG) to gain the views, via an annual survey, of our registered patients. They help to ensure that patients are involved in decisions about the range and quality of the services provided by our practice.

If you are interested in becoming a PRG member, please submit your details using the form below. Providing this information will help us to ensure that the PRG is as representative as possible of our practice population as a whole. The information you supply will be used lawfully, in accordance with the Data Protection Act 1998.

We also have a Patient Participation Group (PPG) which meets about once every three months over sandwiches, so please let us know if you would like to join that group by contacting the practice manager (Lindsay Ward on 01926 810939) and we will invite you to the next meeting. All ages are welcome.

1 Your Details

Please provide in the format dd/mm/yyyy
This will allow us to locate you quickly on our Patient Database.

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 known only to the GP practice and is accessed over a secure connection by nominated Practice staff. Our practice has 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.


© St Wulfstan Surgery - Outstanding CQC 5 Star NHSChoices 2018
Northfield Road, Southam, Warks, CV47 0FG
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