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I confirm that I am a registered patient of the Tutbury Practice and that I wish to become a member of the Tutbury Practice Patient Forum as a;


I understand that, unless I state otherwise, my details above will be kept confidential and only be known to the elected officers of the Forum.


Date Completed

From the - East Staffordshire District Patient Engament Group

Corona Virus Questionnaire

    • The District group consists of elected patient representatives, from each of the various Patient Groups’ within the GP Practices based in East Staffordshire.

      The groups' objective is to come together and discuss areas of good practice and those of concern so that meaningful discussion can be held across the whole spectrum of East Staffordshire GP surgeries.

      This hopefully will lead to the provision of consistent high-quality medical care and services for all patients

      The Group are also a means of 2-way communication from Patient Groups to the Patient Board to the CCG and vice versa. within East Staffordshire.

Click here for our Questionnaire

All information given will be treated in the strictest confidence and will not in any way prejudice your current position / relationship within your practice. Thank you for your time completing this survey.