Patient and Public Representative Expression of Interest

1. Which of the following applies to you?

Please select one

Mandatory

I have been diagnosed with, or received treatment for, cancer in Hull, York, North Yorkshire, East Riding of Yorkshire, North or North East Lincolnshire I care for, or have cared for someone who has been diagnosed with, or who received treatment for, cancer in Hull, York, North Yorkshire, East Riding of Yorkshire, North or North East Lincolnshire

2. Where did you, or the person you care/ cared for, receive their diagnosis or treatment?

Please select one

Mandatory

Hull University Teaching Hospitals NHS Foundation Trust Northern Lincolnshire and Goole NHS Foundation Trust York and Scarborough Teaching Hospitals

3. Which area of Humber and North Yorkshire are you currently living in?

Please select one

Mandatory

Hull York North Yorkshire East Riding of Yorkshire North Lincolnshire North East Lincolnshire

4. What type of cancer have you or the person you care/cared for been diagnosed with?

Mandatory

5. When were you or the person you care/cared for diagnosed with cancer?

Please specify the year.

Mandatory

6. Please summarise why you would like to join Humber and North Yorkshire Cancer Alliance's Patient and Public Representative Group

Mandatory

7. Our Patient and Public Representative Group Meeting currently takes place every other month, often in an afternoon for 2 hours. The meeting is hybrid, with the option of joining in person in our offices in Willerby outside of Hull, or via Teams. Please tick which of the following applies to you:

Mandatory

I would prefer to join meetings in person - I drive and have access to a car I would prefer to join meetings in person - I normally use public transport I would prefer to join meetings online - I have access to a digital device to join online I do not have access to a digital device I would be unable to attend meetings at this time

8. Please state the ways you would like to be involved with Humber and North Yorkshire Cancer Alliance

Please tick all that apply to you

Mandatory

Attending the Patient and Public Representative Group Meeting every other month Joining Humber and North Yorkshire Cancer Alliance Programme Boards or Steering Groups Joining project teams to co-develop patient engagement work Completing surveys to feedback on certain elements of the cancer pathway Volunteering at community engagement events on behalf of Humber and North Yorkshire Cancer Alliance to speak with the public about cancer Advising Cancer Alliance colleagues on materials or messaging being produced for patients and their loved ones Produce a case study outlining your experience of cancer to be shared through the Cancer Alliance's online channels

9. How did you hear about this opportunity?

Mandatory

Via a support group I attend Via a member of staff treating me or the person I care for Through social media At an event Other If you selected 'Other', please state how you heard about this opportunity

Patient and Public Representative Expression of Interest

Page 1 of 2

Survey Closes 31 Dec 2024