Ainsdale Village Surgery, 2 Leamington Road, Ainsdale, Southport, Merseyside, PR8 3LBTel: 01704 577866
We have formed a group and it is our intention to hold meetings at the surgery every few months to discuss the latest practice news and ideas. All patients are very welcome to join the group, your feedback and suggestions are valuable to the smooth running of the practice. If you are interested in this group please ask to speak to the Practice Manager.
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.
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