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Voice membership form

To become a Voice member, please complete the following details.

"*" indicates required fields

Name
Address
Our main contact will be by email. Can we also contact you by:
Confidentiality*
Can we say we are from the Macmillan Information and Support Centre and / or Voice if someone else answers the phone? (Due to confidentiality, our number will not be displayed.)
About you
I am a:
About your interests*
We’d like to know what areas interest you, to help us send you relevant information and news. Please tick one or more boxes.
Do you have any specific areas of interest that you would like to be involved in? For example, chemotherapy, surgery, carers, end of treatment etc. Please write in the box below.
Core Voice Group*
The activities of Voice members are organised by the Core Voice Group. The group meets monthly for two hours, where the interests, needs, and activities of the broader Voice membership are discussed and planned.
Consent*
The information on this form will be kept confidential and not be shared with any external organisations. If you have any questions please speak to staff in the Macmillan Information and Support Centre on the ground floor of Grosvenor Wing, or call 020 8725 2677 or email patient.voice@stgeorges.nhs.uk.