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Carers Voice sign up form

To join Carers Voice, please take a minute to complete the details below. Your answers will help us send you relevant information.

Carers Voice is creating a list of carers who are willing to complete surveys on what they think of health and social care services in Northamptonshire. Thank you for joining this list.
Here we are asking you to tell us something about yourself and the person you look after.

Your answers will be held by Healthwatch Northamptonshire and will be used in such a way that only agreeing carers and past carers can be contacted to answer carer specific surveys on behalf of Carers Voice.

We are collecting the information below to enable us to only send surveys to carers with knowledge of that subject  - we do not want to send you irrelevant information.

We will always take necessary steps to ensure that your information is protected and treated securely. Any details you give us will be held in accordance with the Data Protection Act 2018 (GDPR) and 1998, and our data protection policy and code of practice on confidential and personal information. You may withdraw your consent for us to hold your contact information, where given, at any time by contacting us.  Find out more about how we use data at www.healthwatchnorthamptonshire.co.uk/privacy

To comply with Data Protection Act we can only collect and store personal information that is relevant to the types of services we expect to enquire about. We have left out some possible questions here because they are rarely relevant (e.g. gender of carer, or cared for) or are better asked within a survey, e.g. How long have you been a carer for the cared for? or for how many hours per week do you provide care?

Will you please tell us about yourself and the person you care for by completing the following questions? This should help us to ensure we only ask you to take part in surveys that ask about your experiences as a carer.


Your name
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
4 + 0 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.