NIHR CLAHRC Wessex PPI Registration Form (or preferences change(s))
The NIHR Collaboration for Applied Health Research and Care Wessex (CLAHRC Wessex - see our website: www.clahrc-wessex.nihr.ac.uk/) is committed to working with patients, their families, communities and members of the public to ensure that all its activities are meaningful and useful.

In order to help us to achieve this, we need to identify people who are willing to work with us through patient and public involvement (PPI). If you are interested in helping us, we would be very grateful if you could share some basic information about yourself by completing this form and returning it to Martin Simpson-Scott (contact details at bottom of this page). Please feel free to share with us as much information about yourself as you want.

The personal data you provide will be stored on a password-protected database (full privacy notice detailed at the end of this form, prior to submission). It will not be shared with any third party individuals or organisations without your express permission, and it will be managed in accordance with the General Data Protection Regulation (2018). Upon registering, we will email you periodically with news about the CLAHRC, and about opportunities to work with our researchers. Please feel free to respond only to those opportunities which interest you, and for which you want to find time.

If you have any questions, or if you want to be removed from our database at any time, please contact Martin Simpson-Scott (PPI Coordinator) or email CLAHRC-WessexPPI@soton.ac.uk.

PLEASE ALSO COMPLETE THIS FORM TO CHANGE YOUR CLAHRC WESSEX PREFERENCES...

First name(s): *
Your answer
Surname: *
Your answer
Address Line 1: *
Your answer
Address Line 2: *
Your answer
Address Line 3:
Your answer
Address Line 4:
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Post Code: *
Your answer
Best telephone number:
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Email address:
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I would rather NOT:
How would you prefer to be contacted? *
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