Application to Join our PPG

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



Male: Female:
How would you describe how often you come to the Practice?:
Regularly: Occasionally: Very Rarely:
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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.

Information

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 251134.

Surgery Address

Rising Brook Surgery
Merrey Road,
Stafford.
ST17 9LY

Telephone:
01785 251134