Dudley CCG Permission to Keep In Touch (New Members) Question Title * 1. Title Mr Mrs Ms Master OK Question Title * 2. First Name OK Question Title * 3. Last Name OK Question Title * 4. Organisation/PPG (if applicable) OK Question Title * 5. How would you like us to contact you By email By Post OK Question Title * 6. If you have chosen to be contacted by email, please provide your email address OK Question Title * 7. If you have chosen to be contacted by post, please provide your mail address OK Question Title * 8. Which of the following updates would you prefer to receive? (Please select all that apply.) Newsletter Future events Opportunities to get involved & give feedback Updates on the development of Dudley Multi-specialty Community Provider (MCP). OK Question Title * 9. Please tick the box below to confirm that by providing your information and ticking the above boxes you are consenting to Dudley Clinical Commissioning Group (CCG) processing your data and adding you to our distribution/mailing list. I give consent OK You can change your mind at any time by clicking the unsubscribe button at the bottom of any email you receive, or by contacting us at dudleyccg.contact@nhs.net OK DONE