Be a part of the Royal Surrey County Hospital by becoming a member

It's free, you don't have to do anything and it brings you many benefits

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february

23feb2:00 pm- 4:00 pmFree Health Event - Heart Health - This event is now fully booked

may

4may2:00 pm- 4:00 pmFree Health Event - Respiratory Health
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The benefits

Have your say about your local hospital

Receive electronic newsletters keeping you up to date

Free dedicated member’s magazine twice a year

Free special health information events hosted by our top consultants

Vote to elect the governors who represent you

Express concerns, highlight good practice and benefit from collective influence through your elected governors

Stand for election as a governor to have even more involvement

Join

Just complete the form.

Free membership

Download as PDF

Step #1 Your information

Pekaboo

Step #2 History

Have you been a patient / carer at the hospital in the last 3 years?

Patient
Carer
N/A

Are you happy to be included in the register of public members?

Yes
No

How would you like us to contact you?

Email
Post

Would you be interested in becoming a Governor?

Yes
No

Step #3 Ethic Origin

How would you describe your ethnic origin?

White British
Asian/Pakistani
Black/Caribbean
Mixed White / Black Caribbean
White Irish
Asian Other
Black African
Mixed White Asian
White Other
Chinese
Black / Other
Mixed White / Black African
Other Ethnic Group
Asian / Indian
Asian / Bangladeshi
Other Background

Do you have any particular areas of interest in the hospital?

A&E
Maternity
Diabetes
Children's Services
Cancer
Older People's Care
Learning Disability
Stroke
Other

Do you consider yourself to have a disability?

Yes
No

Confirmation

I am applying to be a member of the Royal Surrey County Hospital NHS Foundation Trust. By signing this form I will be bound by the rules of the organisation and give my consent to my information being processed. This information will be stored and used in accordance with the Data Protection Act 1998. We will only use your information for NHS Foundation Trust status or other health issues.

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Thank you for your submission!

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