To express an interest in joining the Respiratory Lived Experience Panel please fill in the few questions below and return this to us. We will get in touch with you in due course.

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* 1. Name?

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* 2. Contact Telephone Number?

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* 3. Contact email address or postal address?

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* 4. Why are you interested in joining the Respiratory Lived Experience Panel?

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* 5. Do you hold any other voluntary or paid roles in the health and social care sector (i.e. Patient Participation Groups, voluntary group, member of staff)

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