Member details

About you
Your contact details
If we need to, what's a good time to call you?
People who care for other people are important to Healthwatch - whether you care informally (e.g. as a friend or relative), or as a volunteer.
Please give more information about your disability
Completing this will help us check that we are including a wide range of people from across Coventry
Please tell us more about your ethnicity here
Please select at least one option from this list
Please tell us more about the care services you're interested in
Volunteering with Healthwatch Coventry
How many hours can you give each month?
What days and times are you available?
Please tick all the days and times when you might be available
Information from Healthwatch Coventry
Please tell us if you have any communication requirements, e.g. Braille, Large print etc