Sharing and celebrating patient and public participation in healthcare - community grant application form

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Closes 31 Oct 2017

Contact details and eligibility

1. Name of lead person for the project:

2. Job/role title of lead person for the project:

3. Name of your organisation:

4. Address:

5. Telephone number:

6. Email address:

7. Please confirm your eligibility by indicating which of the statements apply to your organisation, by checking the tick boxes next to the description:

You must also ensure that you include your organisation's registration number, for example registered charity number or limited company number.

Please note that if the lead organisation does not fall into one of these categories you are not eligible to apply for this grant.

8. Please explain how your organisation is involving patients and the public to improve health services for the community:

9. Please explain how your project supports/links to at least one of NHS England's priorities:

NHS England's priorities are set out in the Next Steps on the Five Year Forward View (200 words max).

10. Which NHS region are you based in?

11. Are you working with a Sustainability and Transformation Partnership (STP) footprint area? If so, please tell us which one and the name and email address of your contact in the STP.

12. Please list any partner organisations involved in this initiative/project: