Sign up Form

Thank you for agreeing to confirm how you want to hear from us. You can choose how we will contact you and what we will contact you about, as well as the areas in which you are interested in getting involved with.

Your details will only be used for this purpose by Coventry and Rugby CCG and will not be shared with anyone else. The information you supply will be held securely and in accordance with the General Data Protection Regulation (GDPR). You can opt out at any time by contacting us via email contactus@coventryrugbyccg.nhs.uk or telephone 02476 526 824. We will contact you for your consent if there are any changes to the way in which your information is used.

All information provided will be kept on a secure database (MES) held by NHS Coventry and Rugby's CCG in compliance with the General Data Protection Regulation.

If you have any problems filling in the form, or have any other feedback for us, then please email us contactus@coventryrugbyccg.nhs.uk.

1Sign up Form


Privacy Protection

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.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.


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  • Telephone: 02476 553344