Your name/ Client ID Client’s name: Address: Contact Number: DOB: Gender: Ethnicity: Sexuality: Religion: Preferred Language: (for communication purposes) Communication (hearing/visual/literacy difficulties, etc.) How do you want to be involved? Tick the things that interest you Service User Involvement: Use your experience of mental health to make a better Inspire service by attending meetings and helping us with recruitment. Help design, develop and deliver Inspire services as a respected member Co-Production: of our involvement team, become an involvement champion. Peer Support: Join one of our groups and help others by giving emotional, social and practical help. Promoting: Assist us by spreading the word about what the service offers by helping with our marketing/newsletter and/or talking to people in your community. Other: Tell us how else you might like to be involved… Please tell us about any skills or experience that you can bring to the Service User Involvement & Co-Production Service i.e. IT, translation & language skills, administration By providing us your details you are agreeing to us contacting you the work of the Inspire Consortium and other organisations that may provide opportunities for Mental Health Service Users. The information that you provide to us will not be shared with any organisation outside of the Inspire Consortium.
Your name/ Client’s name: Client ID Address: Contact Number: DOB: Gender: Ethnicity: Sexuality: Religion: Preferred Language: (for communication purposes) Communication (hearing/visual/literacy difficulties, etc.) How do you want to be involved? Tick the things that interest you Service User Involvement: Use your experience of mental health to make a better Inspire service by attending meetings and helping us with recruitment. Co-Production: Help design, develop and deliver Inspire services as a respected member of our involvement team, become an involvement champion. Peer Support: Join one of our groups and help others by giving emotional, social and practical help. Promoting: Assist us by spreading the word about what the service offers by helping with our marketing/newsletter and/or talking to people in your community. Other: Tell us how else you might like to be involved… Please tell us about any skills or experience that you can bring to the Service User Involvement & Co-Production Service i.e. IT, translation & language skills, administration By providing us your details you are agreeing to us contacting you the work of the Inspire Consortium and other organisations that may provide opportunities for Mental Health Service Users. The information that you provide to us will not be shared with any organisation outside of the Inspire Consortium.
Registration_Form_1216.docx