Derbyshire Dialogue Registration

Derbyshire Dialogue is an initiative launched by Joined Up Care Derbyshire to hear you, our community, about your experience using the healthcare system, especially within the last 5 months and use this as a learning experience to improve our healthcare system going forward and the way we commission.  A virtual launch session will take place on 10 September to kickstart these conversations, with plans for more interactive sessions being planned for the future.

Please fill out the form below to register your interest to attend the Derbyshire Dialogue virtual session taking place via Microsoft Teams from 11am-12pm on 10 September 2020.

Here is a document outlining how to use Microsoft Teams on the day, for any queries please email karen.lloyd24@nhs.net

Please note that we are using Survey Monkey to collect your name and email address specifically in relation to this virtual session and will not be shared or used to contact you for any other reason without your consent.

Here's more information on Joined Up Care Derbyshire. Please find out more about the Joined Up Care citizen's panel here and an application form here.

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* 1. Please state your name

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* 2. Please state your email address (this will be used specifically in relation to the Derbyshire Dialogue sessions; confirmation emails, sending you a meeting link and post-session surveys etc.)

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* 3. Are you a member of the Joined Up Care Derbyshire citizen's panel?

We would like our Derbyshire Dialogue discussions to be represenative and inclusive of Derbyshire's diverse and vibrant communities. So we would like to ask the below questions with specific regards to diversifying the Derbyshire Dialogue to fairly represent all of our communities and to help make a positive impact to how health and care services are accessed and the experiences that community groups have had using the service.

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* 4. What is your gender?

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* 5. What is your age?

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* 6. What is your ethnic background?

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* 7. What's the first four letters of your post code?

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* 8. By ticking the box below, you consent to Joined Up Care Derbyshire using Survey Monkey to collect your information and to use your data in relation to the delivery of the Derbyshire Dialogue virtual sessions. Your data will be held securely and only used to communicate with you in relation to the Derbyshire Dialogue event.

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