National Bowel Cancer User Group

* denotes required information

1. Title* Mr Mrs Miss Ms Doctor Professor
2. First name*
3. Surname*
4. Job Title*
5. Organisation*
6. Address*
7. Post code*
8. Contact telephone nunmber*
9. Email address*
10. Cancer Network* No specific network Arden Avon, Somerset and Wiltshire Black Country Central South Coast Derby / Burton Dorset Greater Manchester and Cheshire Greater Midlands Cancer Network Humber and Yorkshire Coast Kent and Medway Lancashire and South Cumbria Leicestershire, Northamptonshire and Rutland Merseyside and Cheshire Cancer Network Mid Anglia Mid Trent Mount Vernon Norfolk and Waveney North East London North London North Trent North West Midlands Northern Pan Birmingham Peninsula South East London South Essex South West London Surrey, West Sussex and Hampshire Sussex Teeside, South Durham and North Yorkshire Thames Valley Three Counties West Anglia West London Yorkshire
11. Comments (limited to 1000 characters)*

12. Are you happy for your details to be added to our mailing list?

    yes no

13. Do you wish to receive more information from other Arms Length Bodies?

    yes no

Data protection

The information you provide will be held on The Information Centre for health and social care (The IC) database. The IC will use the information you provide us for marketing, administration, statistical analysis and promotional purposes (including delegate lists and badges). We would like to offer you a monthly e-mail detailing The Information Centre's latest news on our products and services.

In accordance with the requirements of the Data Protection Act 1998, we provide the opportunity for you to be included on our mailing list. Your personal details maybe shared with other NHS organisations that we may be in a position to circulate information to you.

Should you wish your personal data to be removed from our records or updated at a later date, you can request this by contacting enquiries@ic.nhs.uk. Verification of identity will be requested from the data subject before data is removed or amended.