Wessex Cancer Alliance PIN Expression of Interest Form

If you would like to volunteer for the Wessex Cancer Alliance’s Patient, Carer and Public Involvement Network, please complete and return the expression of interest form below. The network is being managed by Wessex Voices, who support the Alliance with their patient and public involvement.

1. Name *


2. Contact details *


3. Preferred method of contact *


4. Please tell us if you are (select all that apply) *


5. Do you have an interest in a specific cancer? Please select all that apply. *


6. Is there a particular area of the Wessex Cancer Alliance’s work that you are interested in? *


7. Please specify what level of involvement you would like to have?

(A) would like to just receive the Wessex Cancer Alliance patient, carer and public information around involvement activities
(B) would like to be an active volunteer with the Alliance on various projects, events and feedback initiatives.

Please note you can change your level of involvement at anytime.


8. If you would like to become a active volunteer, please select all the ways you might like to get involved (sharing your preferences does not automatically commit you to doing these things) *


9. Are there any ways we can support you? (E.g. providing you with translations or accessible information, paying childcare expenses, providing training to access online meetings, etc.)