Covid-19 Out of Hours News

Merritt Gardens, Chessington, Surrey, KT9 2GY

Tel: 020 8397 6361

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ONLINE PATIENT GROUP PARTICIPATION APPLICATION

We have a joint Patient Participation Group for Merrit Medical Centre, this group has members from both Hook Surgery and Chessington Park Surgery. If you would like to be a member, please submit your application and the PPG will contact you.

Personal Details

Your Gender

Your Gender

Your Age Group

Your Age Group

Your Ethnicity

Your Ethnicity

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:

Your Ethnicity

Your Ethnicity

How would you describe how often you come to the practice?

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Information provided by you through this form will allow us to improve our services. The form data undergoes encryption during transmission and while at rest, and will only be retained for a duration sufficient to process your request. You have the option to withdraw your request at any time by notifying the practice. By using this form you are agreeing to our privacy guidelines.

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