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Membership form

Any information you give will be treated confidentially and used only for the purpose of providing you with information and updates about the Trust. All information will be held in accordance with the General Data Protection Regulation and Data Protection Act 2018.

We want to make sure we are attracting people from a variety of culturally diverse backgrounds to assist with our membership being representative of the communities we serve. If you would like to help us monitor how well we are doing this, please indicate your ethnicity from the list below.

 

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Nomination

Name
Gender*
How should we contact you?*
Are you happy for your name to appear on the public register?*

We want to involve all of the communities we serve and to recruit a wide range of members from the people who use our services, their carers, our staff and those who work with us, as well as the wider public.

Foundation Trust membership is divided into constituencies. Please answer the questions below to help us understand which one you want to join.

About you

Have you used NHS community or specialist mental health or learning disability services in the last 5 years?
Are you a carer for someone who has used the above services in the last 5 years?
Are you currently employed by our Trust?

Involvement

You will receive occasional information from the Trust. In addition to that would you like to:
Attend meetings or events?
Consider standing for election to the Members’ Council?
Take part in a patient panel for interviewing staff?

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