Requesting a ��Representative

If you would like a representative from ��to join a working group or committee please provide details in the form below. We will reply as soon as possible but we may not be able to fulfil all requests, particularly those received at short notice. If you have any questions please contact the ��Office, however we are only able to process requests once we have received all of the information contained in the form.

External Representative

Select your organisation if there is a match.

Name of working group or committee

Name of group / committee chair (if known) (optional)

Purpose of the group / committee

What will the representative be expected to do? (Attend meetings, write or review documents etc.)

Are there any ��members already on the group? If yes please provide details. (optional)

Will the group produce a document that you will wish ��to endorse?

Expected Duration of Commitment

Meeting Frequency

Please provide dates of any meetings already scheduled. (optional)

Who can volunteer for this group (consultant, resident doctor, nurse, allied health professional, service user etc.)? If all can apply please write 'any ��member.'

Is this a paid or voluntary position?

Will expenses be covered?

Additional information (optional)

Communication preferences

If you are a human, ignore this field

Requesting a ��������Representative

External Representative

Communication preferences

Requesting a ��Representative