Paxton Green
Group Practice

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PPG Enrolment Form

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All questions marked with a * are mandatory

PPG Enrolment

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May be used to identify you

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As the PPG acts independantly to that of the surgery, we will need to pass on your contact details to enable them to get in touch

This form collects personal and medical information about you and we use this information to allow the practice team to contact you.
Please read our Privacy Policy to discover how we protect and manage your submitted data.

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