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Member Application Form

Become the heartbeat of your local NHS.

Join one of the best performing trusts in the country and help shape local healthcare services for you and your family. Membership is open to anyone aged 12 or over and you can be involved as much or as little as you want. What’s more it’s free.

    Data protection: We will use the personal information you provide on this form to contact you via post, telephone, email and SMS about our trust or other health issues. This is a secure site. The trust may pass this information to third parties which are contracted to provide business support functions in relation to your membership of the trust. Personal information will be passed on to third parties on a confidential basis and will only be used for the purposes specified above. Any comments you submit to the trust will be treated as confidential and will be safeguarded and processed in accordance with the requirements of the Data Protection Act 2018 (GDPR).

    If you wish to opt out of being a foundation trust member you can do so at any time by contacting the foundation membership office on 0191 203 1296 or email

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