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Cystic Fibrosis Trust Involvement Group registration form

This group is made up of individuals whose lives are affected by cystic fibrosis (CF) and who want to support and inform the work of the Trust and other projects that benefit people affected by cystic fibrosis. Members of the group will be contacted as opportunities arise to be involved in Trust projects that aim to have a positive impact on the lives of people affected by cystic fibrosis.

Your feedback, stories, and ideas will help ensure we are acting on the issues that matter most to people living with or affected by cystic fibrosis.

You are not obliged to fill out any/all of the information below, The information will only be used to identify potential relevant involvement opportunities for you, and to help us ensure we are being inclusive in our involvement by involving many different people.


CF TIG please register

Title
*
Name
Forenames
*
Surname
*
Address
Postcode
*
Address line 1
*
Address line 2
Address line 3
Address line 4
Town
*
Telephone
Mobile phone
Landline (incl. area code)
Email
*
Date of Birth
DD/MM/YYYY
*
Relationship with cystic fibrosis
Please choose from the following’





If other please state
Bereavement
I am interested in supporting in these types of activities
Please choose one or more of the below



I am interested in supporting the Trust in these specific fields
Please choose one or more of the below









Have I or the person close to me with CF had a lung transplant?
Please choose one of the below



Other
Do you foresee any barriers to being able to take part in any opportunities we send over?
This question is so we can work toward devising more inclusive involvement opportunities. We will think about these answers when we are designing opportunities.) For example, access to IT, time of day, cross infection, ill health, location etc
Employment Status
Tick as many as apply









Other
How would you describe your sexuality?
Please choose one of the below




Please choose one of the below
Other
The Equality Act 2010 defines a person as having a disability if they have a physical or mental impairment, and that impairment has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities.
Do you consider yourself to be a person with a disability?


Do you consider yourself to be a person with a disability?
How would you describe your gender?
Please choose one of the below



Other
Is your gender identity the same as the gender you were assigned at birth?
Please choose one of the below


Are you a carer?
Please choose one of the below



How would you describe your ethnicity?
Please choose one of the below
















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