Help shape health and care services in your area

Get involved to make our NHS the best it can be

You can play a valuable part in improving local health services by sharing your opinions, thoughts, ideas and concerns with us. If you'd like to be involved in helping shape the future of health and care commissioning, please complete this form.

You could

  • Receive regular news and updates about Warwickshire North health care services
  • Take part in surveys and consultations to help us develop services and spend money in the best way for local people
  • Come to events, health seminars and focus groups
  • Help us sign up more patients across Warwickshire North to share their opinions

If you register, you will be asked for their views on local services and we want your voice to be as representative as possible of the local population. To make sure we are giving everyone the opportunity to have their say, we hope you won’t mind telling us a bit about yourself.

If you'd like to know more about why we ask for this information, please visit our equality and diversity monitoring page.

What we'll do with your details

By providing us with your contact information, you are giving us permission to contact you for the purposes of involvement in health commissioning based on your preferences outlined below. Your details will be stored securely on our database, access to which is restricted and protected, in compliance with the Data Protection Act. If you are not happy for your details to be stored in this way, please do not complete the form.

1About me

By recognising that every patient has different needs and circumstances, the CCG can commission more person-centred services, which best meet those needs and improves outcomes for people. Monitoring gender, ethnicity and sexual orientation as part of other equalities monitoring means that the CCG is able to use this information to better meet the needs of its patients and service users.

If your gender is not listed above, please use this box to let us know how you would describe your gender

2Contact me

We would like to save NHS resources by contacting people by email/social media where possible. If you would prefer us to write to you, please enter your address in the "write to me" box below.

3Information

Examples might include cancer, diabetes, primary care (GP services), maternity and paediatrics, self-care, urgent and emergency care, planned care or all of the above

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key known only to the GP practice and is accessed over a secure connection by nominated Practice staff. Our practice has a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.


© NHS Warwickshire North Clinical Commissioning Group
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