Public Involvement - Expression of Interest Filling in this form will not commit you to anything, it will allow us to contact you again. Name: Address: Postcode: Telephone: Email: How would you prefer to be contacted (it may not always be possible to contact you by your preferred method): Email Phone Post How would you like to be involved? (please tick as few or as many as you wish) Attending public involvement member meetings Reading and commenting on patient/carer information Taking part in Working Groups/Committees Supporting with patient/public consultation Other (please let us know): Please let us know if you have any specific communication requirements (eg braille, large print) I give my consent that my details will be kept on a database by NHS Borders for the purpose of patient and public involvement. I understand that at any time I can withdraw my details from the list. NHS Borders complies with the provisions and obligations of the General Data Protection Regulations (2018) in the storage and retrieval of your personal information. Information will not be disclosed or shared with any external organisations. Message