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National SDE Patient and Public Member event/
15 December online event sign-up form

15 December online event sign-up form

1.

Your name:

* required*

Maximum 255 characters

0/255

2.

Email address:

* required*

3.

Which is your local SDE region?

North East and North Cumbria

North West

Yorkshire and Humber

West Midlands

East Midlands

Great Western

East of England

Wessex

Thames, Valley and Surrey

Kent, Medway and Sussex

London

I'm not sure. Please tell us the county in which you live:

4.

Do you have any accessibility or support requirements, to access Microsoft Teams?

Maximum 255 characters

0/255

5.

Please can you confirm whether or not NHS England can retain your contact details for future communications and events?

Yes, NHS England can retain and contact me again

No, please delete my information

Thank you

Thank you for completing the sign-up form. We will email you shortly to confirm your attendance and details of how to join the online event.

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