As part of our on-going efforts to better serve our patients and the local community, we continue to work with our Patient Representative Group and our patient population to learn more about the people we see and what their needs are.
If you like to become a member of the Lostock Medical Centre patient participation group please inform a member of the reception team.
We would like to know how we can improve our service to
If you are happy for us to contact you occasionally by email please click the link below to open the sign-up form and complete all the fields.
Complete the Patient Group Sign-up Form Online
If you prefer, you can download the sign up form as a pdf document, print it out, complete it and return it to the practice.
Download the pdf version of our sign up form
We will be in touch shortly after we receive your form. Please note that no medical information or questions will be responded to.
Many thanks for your assistance
The information you supply us will be used lawfully, in accordance with the Data Protection Act 1998. The Data Protection Act 1998 gives you the right to know what information is held about you and sets out rules to make sure that this information is handled properly.