Physical Activity Clinical Champions Expressions of Interest booking form
Thank you for your interest in holding a PACC session. Please fill in the details below and we will be in touch with you to confirm a suitable date/time. 

Privacy Statement

All of the information that you provide will be treated as confidential and will only be used for a) sending you information relating to finding out more and booking a PACC session and, b) for  research or service evaluation purposes. Your answers and comments will not be identified as belonging to you, instead they will be combined with those gathered from other survey participants and will be analysed as part of a group. We do not use any of the information you provide for marketing activities or other non-research activities. Our full privacy statement can be found here: PACC Online Survey Privacy Statement - Moving Medicine

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Email *
Name *
Email address *
Job title *
Organisation *
Which ICB are you in? *
Where did you hear about us?  *
Are you wanting to book a group session or as an individual? *
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