Time to Talk (counselling & support) Self referrals
They provide support and counselling to deal with anxiety, stress, depression, work related issues and help with managing chronic medical conditions. Click here to for further details.
Physiotherapy self referral is now available online - see link below
You can also print the form - Physiotherapy self referral form
Download the pdf version of our sign up form
Complete the Patient Reference Group Sign-up Form Online
We would like to know how we can improve our service to you and how you perceive our surgery and staff.
To help us with this, as well as a small face to face group we also have a virtual patient reference group so that you can have your say. We will ask the members of this group some questions from time to time, including input into the design of the survey and how to use the results each year, We will contact you via email/post and keep our communications succinct so it shouldn’t take too much of your time.
We aim to gather anything up to fifty patients from as broad a spectrum as possible to get a truly representative sample. We need young people, workers, retirees, people with long term conditions and people from non-British ethnic groups.
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.
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.
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.
Here at Langley Corner Surgery We are always keen to try to improve our service and welcome feedback from all of our patients. If you could spare a few moments to share some feedback on the service you have received at the surgery then please do click on the Contact Us link and fill in your details.
Contact the Patient Group with your feedback, suggestion, comment or question. Please do not use
this form for complaints - these should always be directed to the Practice Manager
Note that by using this form, you will be sending information about yourself across
the Internet. Whilst every effort is made to keep this information secure, you should
be aware that we cannot offer any guarantees of absolute privacy. If this matter
concerns you then you should use another method to notify us of your comment.
Your IP address (188.8.131.52) will be sent
with your communication. In rare cases where abuse or criminal activity can be shown
to have taken place this may be used by the authorities to trace you.
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