Help shape health and care services in your area
Get involved to make our NHS the best it can be
You can play a valuable part in improving local health services by sharing your opinions, thoughts, ideas and concerns with us. If you'd like to be involved in helping shape the future of health and care commissioning, please complete this form.
- Receive regular news and updates about Coventry and Rugby health care services
- Take part in surveys and consultations to help us develop services and spend money in the best way for local people
- Come to events, health seminars and focus groups
- Help us sign up more patients across Coventry and Rugby to share their opinions
If you register, you will be asked for their views on local services and we want your voice to be as representative as possible of the local population. To make sure we are giving everyone the opportunity to have their say, we hope you won’t mind telling us a bit about yourself.
If you'd like to know more about why we ask for this information, please visit our equality and diversity monitoring page.
What we'll do with your details
By providing us with your contact information, you are giving us permission to contact you for the purposes of involvement in health commissioning based on your preferences outlined below. Your details will be stored securely on our database, access to which is restricted and protected, in compliance with the Data Protection Act. If you are not happy for your details to be stored in this way, please do not complete the form.
Examples might include cancer, diabetes, primary care (GP services), maternity and paediatrics, self-care, urgent and emergency care, planned care or all of the above
If yes, please provide the name of your GP surgey
Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.
All Information submitted through secure forms is secured with a private key known only to the CCG and is accessed over a secure connection by nominated members. Our CCG has a strict confidentiality policy.
This information is not shared with any third party organisations.
On our website:
This information is retained for up to 28 days.
Should you have any concerns about sending your personal details using the web,
please use one of the alternative methods offered by our organisation.