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Membership application form

Thank you for applying to become a member of the Medway NHS Foundation Trust.

Staff members need not complete this form as they are automatically registered as members under the staff category.

Gender
Do you consider yourself to have a disability?
What is your ethnicity?

Declaration

Your details will be held on a database and will be used by the NHS to provide you with information about the work of the Trust and to administer elections to the Council of Governors. The information will remain confidential and will be held and managed in accordance with the General Data Protection Regulations (GDPR). 

You can withdraw your interest at any time by contacting us.