Join Patient Participation Group

Expression of Interest

If you are happy for us to contact you periodically please complete the form below.

Please note that no medical information or questions will be responded to. The information you supply us will be used lawfully, in accordance with the Data Protection Act 1998. The Data Protection Act 1998 gives you the right to know what information is held about you, and sets out rules to make sure that this information is handled properly.

1 Your Details

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

Although sending information across the Internet means that privacy of data cannot be absolutely guaranteed, our online forms offer high levels of security. The forms use HTTPS and TLS (using a 2048 bit certificate) to encrypt data sent to and from your computer when using the site and our server environment is PCI DSS certified - the highest standard of security associated with e-commerce and online finance solutions.

Form submissions are stored on the server for 28 days and are encrypted and secured with a private key known only by the GP Practice.

Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

Your Neighbourhood Professionals Laneways Hypnotherapy Blackstone Solicitors Charlotte Van-Lint Counselling Nutrisential
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21 Dawson Road, West Timperley, Altrincham, Cheshire, WA14 5PF
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Your Neighbourhood Professionals Laneways Hypnotherapy Blackstone Solicitors Charlotte Van-Lint Counselling Nutrisential
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