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About you

Please tell us a little more about you


Please tell us a little about what areas interest you

Your involvement

Please tell us a little more about how you would like to be involved. 


We will send out information by email unless you need information in a different way

How we use your information

We will not pass on your information or data to third parties outside of Healthwatch Coventry without your permission. You can ask Healthwatch to delete your membership information at any time. Find out more about how we safeguard and use information here. 

If Voluntary Action Coventry stops running Healthwatch Coventry we will write to you with your options before passing your contact details to the new organisation.

I confirm that the information given on this form is true and I agree to my information being held on the databases and paper files for the purposes of Healthwatch Coventry.