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6. Are you willing to sign up to the Code of Conduct and Declaration of Interests? *
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7. Are you willing to have your name published as a Healthwatch Volunteer? *
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8. Have you ever had a criminal conviction? *
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9. Are you willing to undertake a DBS check? *
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10. Do you wish to apply for an exemption from attending training workshops on Enter & View or Safeguarding? If yes please upload a statement for panel consideration *
11. File upload for training exemption
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12. Why are you applying to be a Healthwatch Volunteer? (Max. 200 words) *
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13. Are there any areas of health and social care you feel you have experience or expertise? Either as a commissioner, provider or user. (Max. 200 words) *