APEC Volunteer submission form

Be a Patient Voice in Research Projects!

One of the key roles of APEC is to be the patient voice in world class research. This form is for anyone with lived experience of pre-eclampsia/HELLP who would like to be involved in Research work we do.
APEC are involved at every stage of the research process in many projects but we need more patient voices. We need you! If you would like to help please complete the below form.
Name

First Name Last Name
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
E-mail
example@example.com
Would you be able to commit to working on projects with regular meetings a few times a year?

Yes No Other
Would you be prepared to review documents

yes no
Would you be prepared to offer ad-hoc support?

yes no
Would you be prepared to undergo online training?

yes no
Please give a brief description of your experience and when it was.
Thank you very much for getting in touch with APEC. We really appreciate your support.

As a result of this form submission we will contact you to discuss ways in which you could help with future Research Projects APEC will be involved in

If there is anything further you would like to know at this point please do not hesitate to contact Rowan study@apec.org.uk or Marcus mg@marcusgreen.org.uk

We hope to be in contact again soon and thank you.
GDPR

We will not use your data for anything other than internally and never share with outside agencies.
Would you like to receive our monthly electronic newsletters?

yes no
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Be a Patient Voice in Research Projects!