Join

membership form:

What areas of participation are you interested in?

Tell us about your preffered methods of participation

What methods of communication can we use to contact you?

Postal Qustionnaire:

Online/Email Questionnaire:

Email Group/Twitter

Focus Group

Public Meetings:

Business-type Meetings:

One-to-one Meetings

Interview Panels:

Training of Staff:

Developing Communications:

Research and related activities:

Receiving regular information:

Volunteering/helping at events

Other (please specify):

Mental Health Services (Adults):

Mental Health Services (Older People):

Dementia Services:

Carer Issues:

Home Treatment:

Child and Adolescent Services

Eating Disorder Services:

Learning Disability Services:

Inpatient Services:

Community Teams:

Psychological Therapies:

Autistic Spectrum Conditions

Crisis Resolution:

Drug & Alcohol services

Secure Services

Rehabilitation Services

Mental Health Legislation

Mental Capacity Legislation:

Other (please specify):

Post

Phone

Text

Other (please specify):

I accept the above arrangement:

I do not accept the above arrangement:

What sort of participation activity could you be interested in?

The information provided by you in this survey will be held on a database and shared by North Essex Partnership NHS Foundation Trust (NEPFT) and Involving Essex CIC strictly for the purposes of managing the NEPFT Patient & Participation project.

Please acknowledge this statement by selecting your response below:

Mr/Mrs/Miss/Ms/Dr/Other

First Name:

Last Name:

Job Title:

Organisation:

Street and No:

Town:

Post Code:

Email Address:

Phone Number:

Mobile Number:

Patient & Public Participation Project

Please complete your contact details.