Research Advisory Group Application 2022 Question Title * 1. Title Name Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number OK Question Title * 2. Background Information:Please describe your experience and how you have contributed to a discussion group or meeting either as a volunteer or in the work place. OK Question Title * 3. Please explain why you want to become a patient advisor and what think you can contribute (Max 200 words) OK Question Title * 4. Have you been or are you involved in the work of any other NIHR or NHS Involvement or Engagement group? Your answer will not affect your application in any way. Please insert an X next to your answer. Yes - If yes please give details No OK Question Title * 5. Do you have any support requirements in order to be able to participate fully in this recruitment process? Yes No Other (please specify) OK Question Title * 6. How did you hear about this opportunity? OK DONE