Service user and carer additional involvement

1. What is your name?

2. Please tick the boxes to say which areas you would particularly wish to support

	Adult Nursing	Children's nursing	Midwifery(recent)	Mental Health Nursing	Paramedic Medicine	Occupational Therapy	Physiotherapy
I have personal experience of this service	I have personal experience of this service Adult Nursing	I have personal experience of this service Children's nursing	I have personal experience of this service Midwifery(recent)	I have personal experience of this service Mental Health Nursing	I have personal experience of this service Paramedic Medicine	I have personal experience of this service Occupational Therapy	I have personal experience of this service Physiotherapy
I could share my experience with students	I could share my experience with students Adult Nursing	I could share my experience with students Children's nursing	I could share my experience with students Midwifery(recent)	I could share my experience with students Mental Health Nursing	I could share my experience with students Paramedic Medicine	I could share my experience with students Occupational Therapy	I could share my experience with students Physiotherapy
I am interested in curriculum development	I am interested in curriculum development Adult Nursing	I am interested in curriculum development Children's nursing	I am interested in curriculum development Midwifery(recent)	I am interested in curriculum development Mental Health Nursing	I am interested in curriculum development Paramedic Medicine	I am interested in curriculum development Occupational Therapy	I am interested in curriculum development Physiotherapy
I could commit time to course ratification	I could commit time to course ratification Adult Nursing	I could commit time to course ratification Children's nursing	I could commit time to course ratification Midwifery(recent)	I could commit time to course ratification Mental Health Nursing	I could commit time to course ratification Paramedic Medicine	I could commit time to course ratification Occupational Therapy	I could commit time to course ratification Physiotherapy
I would like to help recruit suitable students	I would like to help recruit suitable students Adult Nursing	I would like to help recruit suitable students Children's nursing	I would like to help recruit suitable students Midwifery(recent)	I would like to help recruit suitable students Mental Health Nursing	I would like to help recruit suitable students Paramedic Medicine	I would like to help recruit suitable students Occupational Therapy	I would like to help recruit suitable students Physiotherapy

3. Do you have any further ideas of how you would like to help support our students and course delivery

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