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Patient Participation Group (PPG)
PPG Questionnaire
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PPG Questionnaire
Last Updated: Tuesday, 26 August 2025
PPG Questionnaire
First name
*
Last name
*
DOB
Postcode
*
Which practice are you registered to?
*
-- Please select --
Central (Pembroke Place/Ropewalks/Student Health)
Kensington Neighbourhood Health Centre
Princes Park Health Centre
Marybone Health Centre
Do you have children under the age of 16?
*
Yes
No
Occupation / Working status
-- Please select --
Employed
Unemployed
Retired
Refugee
Seeking Asylum
Other (please state below)
Other
To help direct us, are there any of the below you would like to discuss?
1. Long term conditions
2. Cancer referral/Screening and support
3. Transgender/LGBTQIA community
4. Refugee/Asylum support in registration, Primary Care education and support in translation
5. Baby immunisation
6. Mental health
7. Support for informal carers
8. Dementia
9. Patients with learning difficulties
10. Support for homeless patients
11. Referrals for social/health & well being needs such as Weight Management programmes, stop smoking support. Please state below -
If ‘Other’ or further detail, please state below
Which would work best?
Virtual
Face-to-face
Time?
4-5pm
5-6pm
6-7pm
Frequency?
Monthly
Bi-monthly (every 2 months)
Quarterly (every 3 months)
Would you like all sites together or site specific?
All sites together
Site specific
Submit
Contents
PPG Questionnaire
