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Patient Reference Group

Please complete the following fields and press submit to join our Patient Reference Group. (* Mandatory Fields)

1Contact information

to receive confirmation of your request

2Additional information

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.

Please select your age group

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key known only to the GP practice and is accessed over a secure connection by nominated Practice staff. Our practice has a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

Learn more about our Privacy Policy and Terms of Use. 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. Just a Click Away!
South Square, Boston, Lincolnshire , PE21 6JU
  • Telephone 01205 311133
Website supplied by Oldroyd Publishing Group
Your Neighbourhood Professionals. Just a Click Away!
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