Trumpington Street Medical Practice

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Patient Group

Would you like to have your say about the services provided at Trumpington Street Medical Practice and Trumpington Surgery?

We would like to hear your views.

By providing your email details we can add them to a contact list that will mean we can contact you by email every now and again to ask a question or two.

Fill in this form and we will add your email address to our contact list:

Name:
Email address:
Postcode:

This additional information will help to make sure we try to speak to a representative sample of the patients that are registered at this practice.

Gender:
Age Group:

To help us ensure our contact list is representative of our local community please indicate which of the following ethnic background you would most closely identify with?

Ethnic Background:
White	British Group Irish
Mixed	White/Black Caribbean White & Black African White & Asian
Asian or Asian British	Indian Pakistani Bangladeshi
Black or Black British	Caribbean African
Chinese or other ethnic Group	Chinese Any Other
How would you describe how often you come to the practice?


Thank You. 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. Patient Survey Findings Click here to download Patient Participation Report Click here to download

Trumpington Street
Medical Practice
56 Trumpington Street
Cambridge
CB2 1RG

Tel: 01223 361611

PRACTICE BOOKLET

If you wish to download a printable Practice Booklet please click here.

Please note you will need Adobe Reader installed on your computer to view the Booklet.

It can be downloaded free at www.adobe.com