Application to Join our PPG

As a registered patient, you can use the form below to apply to join the Mill Bank Surgery Patient Participation Group:

Male: Female:
How would you describe how often you come to the Practice?:
Regularly: Occasionally: Very Rarely:
Please enter the code shown above:

Terms & Conditions: By entering the code above, you also confirm that you have read and agree with the Terms and Conditions (including Privacy & Cookies Policies and Medical Disclaimer) for this website.

Do I Need to Use this Form to Join?

No, you can also apply in writing to our postal address, or call our Practice Manager on 01785 258348.

Surgery Address

Mill Bank Surgery
Water Street
ST16 2AG


01785 258348
(four lines)