The information that you provide on this form will be used by Wolverhampton CCG
to contact you about local health care services/activities and to inform you of the
ways in which you can get involved. We will also inform you of events being run by
our partner agencies. If after registering it is found that you live within the boundaries
of a different CCG, then your details will be forwarded on to that CCG. Midlands and
Lancashire CSU help manage the Patient Partners scheme along with the CCG and
will have access to your data. Your details will only be used for this purpose and will
not be shared with anyone else.
The information you supply will be held securely and in accordance with the Data
Protection Act 1998. You can opt out of the Patient Partners scheme at any time
by contacting the Communications and Engagement team on 01902 444878. We
will contact you for your consent if there are any changes to the way in which your
information is used.
Are your day to day activities limited by a health problem or disability which has lasted or is expected to last over 12 months?
Tell us what areas you are interested in:
How would you like us to keep in touch with you?
How would you like to be involved? Please select all that apply: