This is your opportunity to have a say and help to shape the Young Fabian Health Network. The strength of the network is in the diversity of experiences, skills and expertise of you, the members. To help us build an effective, strong and diverse network we want to find out more about you, what you do and how you would like to get involved.

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* 1. What is your name?

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* 2. Your email address

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* 3. Which region/nation do you live in?

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* 4. Would you be interested in developing the Young Fabian Health Network in your region with other members?

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* 5. What do you do?

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* 6. Please describe your specialism and where you work. If you are a student, please tell us what you are you studying.

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* 7. Which of the following opportunities would you be interested in?

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* 8. Which of the following topics would you be interested in contributing to work on?

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* 9. Any other ideas?
We want to hear from you! Please let us know about any other ideas you have for the Young Fabian Health Network. This could be suggestions for blog articles, events, speakers, ways of engaging members or any other ideas for developing the network.

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* 10. Thank you for the taking the time to respond to this survey.
Your responses will be stored securely and confidentially in line with the Fabian Society's privacy policy - read here for further information: http://fabians.org.uk/privacy-policy/

The answers you provide will be used by the Young Fabian Health Network to develop the direction of the network. We may contact you in relation to your responses. The personal information you tell us in this survey will be stored for no more than three years and you can request that your data is deleted at any time by contacting healthnetwork@youngfabians.org.uk.

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