Become a supporter

By signing up as a supporter you will receive our monthly e-newsletter which contains:

- updates about our work

- upcoming projects

- local health and social care news

- information on ways to get involved

You will also receive occasional emails about important pieces of work where you can have your say, such as invitations to complete surveys or to come to our quarterly Public Forum events. You can also ask us to share FREE or low cost community events and activities for local people to know about (relating to health and social care).

1. Your title

2. First name

3. Surname

4. Address including postcode

If you don’t feel comfortable sharing your full address, please give the postcode as it allows us to find out which areas of the borough we are reaching.

5. Email address

6. Phone number (optional)

7. Are you getting involved as an individual or as a representative of an organisation?

If an organisation, what is its name?

And what are its aims?

8. What is your gender?

9. Do you consider yourself to have a disability?

Yes

Prefer not to say

If yes, please specify...

10. How would you describe your ethnicity?

If 'other', please specify...

11. Please give your month and year of birth.

Whilst we will keep your data as safe as possible, we know that some people don’t feel comfortable sharing their full date of birth. By giving us the month and year you enable us to calculate on a quarterly basis the age range of our supporters.

12. How did you hear about Healthwatch Southwark?

13. Anything else you'd like to tell us?

Email: info@healthwatchsouthwark.co.uk

Telephone: 0207 358 7005

Upcoming events

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May 17

Become a supporter

Recent news

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Healthwatch Southwark is a project of Community Southwark |

Community Southwark is a registered charity (no. 1105835) and a company limited by guarantee in England and Wales (no. 5090324)