Advocacy Workshop 15 July 2020

Thank you for your interest in Action for M.E.'s Advocacy Workshop

The workshop will take place online, 11am to 1pm, Wednesday 15 July 2020.

In order to register for the workshop, please sign up by answering the questions below. You will then be emailed full joining instructions.

This free workshop is funded by Healthwatch BANES Community Pot. In the session we will cover:

- What is advocacy, and how can I self-advocate?

- Tools, tips and suggestion to empower you to self-advocate

We look forward to you joining the workshop.

Question Title

* 1. First Name

Question Title

* 2. Surname

Question Title

* 3. Email

Question Title

* 4. Telephone Number

Question Title

* 5. Postcode

Question Title

* 6. Please tick the box which best describes you:

I am an adult with M.E./CFS

I care for someone with M.E./CFS

Other (please specify)

Question Title

* 7. In order to better understand who is accessing our project, our funders have asked us to collect the following data on age, gender, ethnicity and disability. Any information you provide will be anonymised before it is seen by the funder. Thank you for completing these questions.

Please select your age:

18 - 25

26 - 35

36 - 45

46 - 55

56 - 65

66 - 75

76+

Prefer not to say

Question Title

* 8. Please tell us your gender:

Question Title

* 9. Please tell us your ethnicity:

Asian British

Asian Bangladeshi

Asian Indian

Asian Pakistani

Asian - Other

Black British

Black African

Black Caribbean

Black - Other

Chinese

Mixed Race - White and Asian

Mixed Race - White and Black African

Mixed Race - White and Black Caribbean

Mixed Race - White and Chinese

Mixed Race - Other

White British

White Irish

White - Other

Other - not listed above

Prefer not to say

Question Title

* 10. Do you consider yourself to have a disability?

Yes

Prefer not to say

Question Title

* 11. If you answered yes to Q10, please indicate which category/categories best describes your disability:

Hearing impairment

Visual impairment

Speech impairment

Mobility impairment

Physical co-ordination (e.g. manual dexterity/muscle control)

Reduced physical capacity (e.g. severe pain, lack of strength, breath or stamina)

Learning difficulties

Mental illness

N/A

Other (please specify)

Question Title

* 12. To help us tailor the workshop, please tell us what health and social care services you have accessed in the last 12 months:

(service)

Question Title

* 13. How did you find out about this workshop?

Question Title

* 14. Do you have any accessibility requirements for the workshop?

Question Title

* 15. Finally, please let us know if there is anything you would particularly like to gain from the workshop:

Question Title

* 16. DATA PROTECTION STATEMENT
We collect personal data in order to provide services. However, we only use these details to provide the service the person has requested and for other closely related purposes. For more information please see our Privacy Policy on the Action for M.E. website.

I give permission for Action for M.E. to process my personal data:

Yes