How To Get Involved

Q1. How you can get involved (please tick your preferred choices)
By Post (eg questionnaires, surveys)
Join the readers panel - if you are interested in how information is provided, enjoy reading and would be able to comment and make suggestions on the language used and layout of leaflets then join the readers panel
Have your say (available on our website: www.kirklees-pct.nhs.uk or within your local community, eg library, GP surgery, pharmacy, leisure centre)
Join the Local Involvement Network (LINk). From 1st April 2008 a LINk will replace the PPI forum. LINks will make it easier for local people to have a voice in shaping the future of health and social care.
Become a volunteer for NHS Kirklees
Participation in a focus group.

Q2. Your areas of interest (please tick your preferred choices - these are only a few examples)

Primary care services
District Nursing
Intermediate Care
GP Services
Health Visiting
Contraception and Sexual Health
Dental Services
School Health Servcies

Services for children and young people
Health visiting
School health visiting
Children with learning difficulties
Child development team

Health promotion
Smoking
Diet
Physical activity
Healthy eating

Podiatry services
foot management i.e. ingrown toenails, warts, etc

Mental health services
Home treatment team
Community mental health team
Counselling services
Acute beds

Chronic/long term conditions
Diabetes
Heart disease
Arthritis
Respiratory conditions (such as lung disease, asthma etc)

Neurological conditions
Epilepsy
Stroke
Parkinson's disease
Multiple sclerosis
Alzheimer’s disease

Specialist community services
Sickle cell service
Asian cancer project
Tuberculosis

Other
Please specify

Q3. Personal details

Title
Forename
Surname
Address
Postcode
Tel
Email

Sex
Male
Female

Which age group are you? (optional)
16-24
25-34
35-44
45-54
55-64
65 and over

How would you best describe your ethnic origin? (optional)
White
British
Irish
Other White
Asian or Asian British
Indian
Pakistani
Bangladeshi
Other background
Mixed
White and black Caribbean
White and black African
White and Asian
Other mixed background
Black or Black British
Caribbean
African
Other black
Chinese or other ethnic group:
Chinese
Any other